Predictors of anterior pituitary insufficiency after traumatic brain injury

Clin Endocrinol (Oxf). 2008 Feb;68(2):206-12. doi: 10.1111/j.1365-2265.2007.03020.x. Epub 2007 Sep 4.

Abstract

Background: Several studies have reported a high prevalence of hypopituitarism after traumatic brain injury (TBI). Risk stratification is a prerequisite for cost-effective hormonal screening of these patients. However, it is still unclear which risk factors predispose patients to develop anterior hypopituitarism after TBI.

Objective: To assess clinical and radiological risk factors for post-traumatic hypopituitarism.

Patients and methods: Seventy-eight consecutive patients (52 men, 26 women; mean age 36.0 years, range 18-65 years) with mild, moderate or severe TBI were studied. Endocrine and clinical parameters were assessed 3 and 12 months after TBI.

Results: We found diffuse axonal injury, basal skull fracture and older age to be major risk factors of post-traumatic hypopituitarism.

Conclusions: We have defined specific risk factors for the development of post-traumatic hypopituitarism that are consistent with pathophysiological considerations. These findings might help to identify at-risk patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Brain Injuries / blood*
  • Brain Injuries / complications*
  • Brain Injuries / diagnostic imaging
  • Brain Injuries / metabolism
  • Estradiol / blood
  • Female
  • Follicle Stimulating Hormone / blood
  • Humans
  • Hypopituitarism / blood*
  • Hypopituitarism / diagnostic imaging
  • Hypopituitarism / etiology*
  • Hypopituitarism / metabolism
  • Insulin-Like Growth Factor I / metabolism
  • Luteinizing Hormone / blood
  • Male
  • Middle Aged
  • Pituitary Hormones, Anterior / blood
  • Prolactin / blood
  • Prospective Studies
  • Radiography
  • Risk Factors
  • Testosterone / blood
  • Thyrotropin / blood
  • Thyroxine / blood
  • Triiodothyronine / blood
  • Young Adult

Substances

  • Pituitary Hormones, Anterior
  • Triiodothyronine
  • Testosterone
  • Estradiol
  • Insulin-Like Growth Factor I
  • Prolactin
  • Luteinizing Hormone
  • Follicle Stimulating Hormone
  • Thyrotropin
  • Thyroxine