Indian Journal of Neurotrauma 2012; 09(02): 123-128
DOI: 10.1016/j.ijnt.2012.11.005
Review Article
Thieme Medical and Scientific Publishers Private Ltd.

Endocrine manifestations of traumatic brain injury

Amit Agrawal
a   Professor of Neurosurgery, Department of Neurosurgery, Narayana Medical College Hospital, Chinthareddypalem, Nellore 524003, Andhra Pradesh, India
,
P. Amareesh Reddy
b   Assistant Professor of Endocrinology, Department of Endocrinology, Narayana Medical College Hospital, Chinthareddypalem, Nellore, Andhra Pradesh, India
,
N. Rajendra Prasad
c   Senior Resident of Endocrinology, Department of Endocrinology, Narayana Medical College Hospital, Chinthareddypalem, Nellore, Andhra Pradesh, India
› Author Affiliations

Subject Editor:
Further Information

Publication History

13 June 2012

25 November 2012

Publication Date:
06 April 2017 (online)

Abstract

Traumatic brain injury (TBI) is one of the causes of morbidity and mortality in young males, with consequences ranging from physical disabilities to cognitive, behavioral, psychological and social impairments. Traumatic brain injury (TBI) is a devastating public health problem and current data clearly establish that it may result in pituitary dysfunction in up to 20–50% have some degree of pituitary dysfunction after TBI. Although most cases of post-traumatic neuroendocrine dysfunction seem to be transient, persistent mild deficiency of pituitary hormones can be overlooked, as patients might have less-severe symptoms and their clinical course is often complicated by significant neurological disabilities. Presently there is paucity of prospective data on the natural history of post-traumatic neuroendocrine dysfunctions and there is need to develop appropriate guidelines for follow-up of suspected to have these dysfunctions so the information can lead to timely and appropriate assessment and treatment of hormonal deficits.

 
  • References

  • 1 Khan F., Baguley I.J., Cameron I.D.. 4: Rehabilitation after traumatic brain injury. Med J Aust 2003; 178: 290-295
  • 2 Salazar A.M., Warden D.L., Schwab K.. et al Cognitive rehabilitation for traumatic brain injury: a randomized trial. Defense and Veterans Head Injury Program (DVHIP) Study Group. JAMA 2000; 283: 3075-3081
  • 3 Agrawal A., Galwankar S., Kapil V.. et al Epidemiology and clinical characteristics of traumatic brain injuries in a rural setting in Maharashtra, India. 2007–2009. Intern J Crit Illness Inj Sci 2012; 02: 167-171
  • 4 Agrawal A, Kakani A, Baisakhiya N, Galwankar S, Dwivedi S, Pal R. Developing traumatic brain injury data bank: prospective study to understand the pattern of documentation and presentation. Indian J Neurotrauma; 2012.
  • 5 Aimaretti G., Ambrosio M.R., Di Somma C.. et al Residual pituitary function after brain injury-induced hypopituitarism: a prospective 12-month study. J Clin Endocrinol Metab 2005; 90: 6085-6092
  • 6 Kelly D.F., Gonzalo I.T., Cohan P., Berman N., Swerdloff R., Wang C.. Hypopituitarism following traumatic brain injury and aneurysmal subarachnoid hemorrhage: a preliminary report. J Neurosurg 2000; 93: 743-752
  • 7 Tanriverdi F., Senyurek H., Unluhizarci K., Selcuklu A., Casanueva F.F., Kelestimur F.. High risk of hypopituitarism after traumatic brain injury: a prospective investigation of anterior pituitary function in the acute phase and 12 months after trauma. J Clin Endocrinol Metab 2006; 91: 2105-2111
  • 8 Tanriverdi F., De Bellis A., Bizzarro A.. et al Antipituitary antibodies after traumatic brain injury: is head trauma-induced pituitary dysfunction associated with autoimmunity?. Eur J Endocrinol 2008; 159: 7-13
  • 9 Poomthavorn P., Maixner W., Zacharin M.. Pituitary function in paediatric survivors of severe traumatic brain injury. Arch Dis Child 2008; 93: 133-137
  • 10 Cyran E.. Hypophysenschà digung durch schà delbasisfraktur. Dtsch Med Wochenschr 1918; 44: 1261
  • 11 Schneider H.J., Aimaretti G., Kreitschmann-Andermahr I., Stalla G.K., Ghigo E.. Hypopituitarism. Lancet 2007; 369: 1461-1470
  • 12 Benvenga S., Campenni A., Ruggeri R.M., Trimarchi F.. Clinical review 113: hypopituitarism secondary to head trauma. J Clin Endocrinol Metab 2000; 85: 1353-1361
  • 13 Agha A., Rogers B., Mylotte D.. et al Neuroendocrine dysfunction in the acute phase of traumatic brain injury. Clin Endocrinol 2004; 60: 584-591
  • 14 Agha A., Thompson C.J.. Anterior pituitary dysfunction following traumatic brain injury (TBI). Clin Endocrinol (Oxf) 2006; 64: 481-488
  • 15 Aimaretti G., Ambrosio M.R., Di Somma C.. et al Traumatic brain injury and subarachnoid haemorrhage are conditions at high risk for hypopituitarism: screening study at 3 months after the brain injury. Clin Endocrinol 2004; 61: 320-326
  • 16 Bondanelli M., De Marinis L., Ambrosio M.R.. et al Occurrence of pituitary dysfunction following traumatic brain injury. J Neurotrauma 2004; 21: 685-696
  • 17 Kornblum R.N., Fisher R.S.. Pituitary lesions in craniocerebral injuries. Arch Pathol 1969; 88: 242-248
  • 18 Kreitschmann-Andermahr I., Hoff C., Saller B.. et al Prevalence of pituitary deficiency in patients after aneurysmal subarachnoid hemorrhage. J Clin Endocrinol Metab 2004; 89: 4986-4992
  • 19 Leal-Cerro A., Flores J.M., Rincon M.. et al Prevalence of hypopituitarism and growth hormone deficiency in adults long-term after severe traumatic brain injury. Clin Endocrinol (Oxf) 2005; 62: 525-532
  • 20 Schneider H.J., Kreitschmann-Andermahr I., Ghigo E., Stalla G.K., Agha A.. Hypothalamopituitary dysfunction following traumatic brain injury and aneurysmal subarachnoid hemorrhage: a systematic review. JAMA 2007; 298: 1429-1438
  • 21 Schneider M., Schneider H., Yassouridis A., Saller B., Von Rosen F., Stalla G.. Predictors of anterior pituitary insufficiency after traumatic brain injury. Clin Endocrinol 2007; 68: 206-212
  • 22 Schneider H.J., Schneider M., Saller B.. et al Prevalence of anterior pituitary insufficiency 3 and 12 months after traumatic brain injury. Eur J Endocrinol 2006; 154: 259-265
  • 23 Teasdale G., Jennett B.. Assessment of coma and impaired consciousness. A practical scale. Lancet 1974; 02: 81-84
  • 24 Klose M., Juul A., Poulsgaard L., Kosteljanetz M., Brennum J., Feldt-Rasmussen U.. Prevalence and predictive factors of post-traumatic hypopituitarism. Clin Endocrinol 2007; 67: 193-201
  • 25 Berg C., Oeffner A., Schumm-Draeger P.M.. et al Prevalence of anterior pituitary dysfunction in patients following traumatic brain injury in a German multi-centre screening program. Exp Clin Endocrinol Diabetes 2009; 118: 139-144
  • 26 Agha A., Rogers B., Sherlock M.. et al Anterior pituitary dysfunction in survivors of traumatic brain injury. J Clin Endocrinol Metab 2004; 89: 4929-4936
  • 27 Popovic V., Pekic S., Pavlovic D.. et al Hypopituitarism as a consequence of traumatic brain injury (TBI) and its possible relation with cognitive disabilities and mental distress. J Endocrinol Investig 2004; 27: 1048-1054
  • 28 Herrmann B.L., Rehder J., Kahlke S.. et al Hypopituitarism following severe traumatic brain injury. Exp Clin Endocrinol Diabetes 2006; 114: 316-321
  • 29 Bavisetty S., Bavisetty S., McArthur D.L.. et al Chronic hypopituitarism after traumatic brain injury: risk assessment and relationship to outcome. Neurosurgery 2008; 62: 1080-1094
  • 30 Ceballos R.. Pituitary changes in head trauma (analysis of 102 consecutive cases of head injury). Ala J Med Sci 1966; 03: 185-198
  • 31 Crompton M.R.. Hypothalamic lesions following closed head injury. Brain 1971; 94: 165-172
  • 32 Harper C.G., Doyle D., Adams J.H., Graham D.I.. Analysis of abnormalities in pituitary gland in non-missile head injury: study of 100 consecutive cases. J Clin Pathol 1986; 39: 769-773
  • 33 Pierucci G., Gherson G., Tavani M.. Pituitary changes especially necrotic-following cranio-cerebral injuries. Pathologica 1971; 63: 71
  • 34 Salehi F., Kovacs K., Scheithauer B.W., Pfeifer E.A., Cusimano M.. Histologic study of the human pituitary gland in acute traumatic brain injury. Brain Inj 2007; 21: 651-656
  • 35 Yuan X.Q., Wade C.E.. Neuroendocrine abnormalities in patients with traumatic brain injury. Front Neuroendocrinol 1991; 12: 209-230
  • 36 Zaben M., El Ghoul W., Belli A.. Post-traumatic head injury pituitary dysfunction. Disabil Rehabil 2012; 1-4
  • 37 Benvenga S., Campennà A., Ruggeri R.M., Trimarchi F.. Hypopituitarism secondary to head trauma. J Clin Endocrinol Metab 2000; 85: 1353-1361
  • 38 Nachtigall L.B.. Brain injury and pituitary dysfunction. Brain Inj 2005; 11
  • 39 Tanriverdi F., Ulutabanca H., Unluhizarci K., Selcuklu A., Casanueva F.F., Kelestimur F.. Three years prospective investigation of anterior pituitary function after traumatic brain injury: a pilot study. Clin Endocrinol 2008; 68: 573-579
  • 40 Agha A., Sherlock M., Phillips J., Tormey W., Thompson C.J.. The natural history of post-traumatic neurohypophysial dysfunction. Eur J Endocrinol 2005; 152: 371-377
  • 41 Agha A., Phillips J., O'Kelly P., Tormey W., Thompson C.J.. The natural history of post-traumatic hypopituitarism: implications for assessment and treatment. Am J Med 2005; 118: 1416
  • 42 Cooper K.D., Tabaddor K., Hauser W.A., Feiner C., Factor P.. The epidemiology of head injury in the Bronx; pp. 70–78. Neuroepidemiology 1983; 02: 70-78
  • 43 Behan L.A., Agha A.. Endocrine consequences of adult traumatic brain injury. Hormone Res Paediatr 2007; 68: 18-21
  • 44 Bondanelli M., Ambrosio M.R., Cavazzini L.. et al Anterior pituitary function may predict functional and cognitive outcome in patients with traumatic brain injury undergoing rehabilitation. J Neurotrauma 2007; 24: 1687-1698
  • 45 Baalen B.V., Odding E., Maas A.I.R., Ribbers G.M., Bergen M.P., Stam H.J.. Traumatic brain injury: classification of initial severity and determination of functional outcome. Disabil Rehabil 2003; 25: 9-18
  • 46 Wallymahmed M., Foy P., MacFarlane I.. The quality of life of adults with growth hormone deficiency: comparison with diabetic patients and control subjects. Clin Endocrinol (Oxf) 1999; 51: 333-338
  • 47 Klose M., Watt T., Brennum J., Feldt-Rasmussen U.. Posttraumatic hypopituitarism is associated with an unfavorable body composition and lipid profile, and decreased quality of life 12 months after injury. J Clin Endocrinol Metab 2007; 92: 3861-3868
  • 48 Brandt L., Saveland H., Valdemarsson S., Sjoholm H., Reinstrup P.. Fatigue after aneurysmal subarachnoid hemorrhage evaluated by pituitary function and 3D-CBF. Acta Neurol Scand 2004; 109: 91-96
  • 49 Lieberman S.A., Oberoi A.L., Gilkison C.R., Masel B.E., Urban R.J.. Prevalence of neuroendocrine dysfunction in patients recovering from traumatic brain injury. J Clin Endocrinol Metab 2001; 86: 2752-2756
  • 50 Schneider H.J., Herrmann B.L., Schneider M., Sievers C., Schaaf L., Stalla G.K.. Discrepant results in the diagnosis of GH deficiency with the insulin-tolerance test and the GHRH plus arginine test in patients with traumatic brain injury. Eur J Endocrinol 2006; 155: 553-557
  • 51 Schneider H.J., Sãmann P., Schneider M.. et al Pituitary imaging abnormalities in patients with and without hypopituitarism after traumatic brain injury. J Endocrinol Investig 2007; 30 (04) RC9-RC12
  • 52 Agha A., Thornton E., O'Kelly P., Tormey W., Phillips J., Thompson C.J.. Posterior pituitary dysfunction after traumatic brain injury. J Clin Endocrinol Metab 2004; 89: 5987-5992
  • 53 Makulski D.D., Taber K.H., Chiou-Tan F.Y.. Neuroimaging in posttraumatic hypopituitarism. J Comput Assist Tomogr 2008; 32: 324-328
  • 54 Maiya B., Newcombe V., Nortje J.. et al Magnetic resonance imaging changes in the pituitary gland following acute traumatic brain injury. Intensive Care Med 2008; 34: 468-475
  • 55 Craciunas S.C., Cirstea C.M., Yeh H.W.. et al Longitudinal volumetric MRI study of pituitary gland following severe traumatic brain injury. Rom Neurosurg 2012; 03: 193-202
  • 56 Bernard F., Matta B.F.. Adrenal insufficiency after brain injury. Intensive Care Med 2006; 32: 793
  • 57 Pickel J, Schneider HJ, Stalla GK. Hypopituitarism and brain injury: recent advances in screening and management. F1000 Med Reports. 2009;1.
  • 58 Sesmilo G., Halperin I., Puig-Domingo M.. Endocrine evaluation of patients after brain injury: what else is needed to define specific clinical recommendations?. Hormones 2007; 06: 132
  • 59 Ghigo E., Masel B., Aimaretti G.. et al Consensus guidelines on screening for hypopituitarism following traumatic brain injury. Brain Inj 2005; 19: 711-724
  • 60 LaChapelle D.L., Finlayson M.. An evaluation of subjective and objective measures of fatigue in patients with brain injury and healthy controls. Brain Inj 1998; 12: 649-659
  • 61 Agha A., Sherlock M., Thompson C.. Post-traumatic hyponatraemia due to acute hypopituitarism. QJM 2005; 98: 463-464
  • 62 Cohan P., Wang C., McArthur D.L.. et al Acute secondary adrenal insufficiency after traumatic brain injury: a prospective study. Crit Care Med 2005; 33: 2358-2366