Assessment of neuroendocrine dysfunction following traumatic brain injury.
Posttraumatic neuroendocrine pathology may be a clinically significant complication following traumatic brain injury (TBI). Metabolic abnormalities are described after TBI in two cases. A 21 year old male injured in a motor vehicle accident admitted in a minimally responsive condition presented with fluctuating high sodium levels, undetectable serum testosterone, and depressed cortisol and thyroid function. Imaging revealed near complete avulsion of the pituitary stalk leading to panhypopituitarism. A 38 year old male admitted for occipital skull fractures and brain contusions presented with hyponatremia and low serum testosterone. Both patients required hormonal replacement and correction of electrolyte abnormalities. A screening protocol adapted for selected patients at risk for endocrine problems is described. While neuroendocrine screening is not advocated in all TBI patients, physicians should be aware of the importance of neuroendocrine dysfunction following TBI.
Childers
M K
MK
Department of Physical Medicine and Rehabilitation, University of Missouri-Columbia, Howard A. Rusk Rehabilitation Center, USA.
Rupright
J
J
Jones
P S
PS
Merveille
O
O
D000328:Adult; D001930:Brain Injuries / Q000097:blood / Q000150:complications* / Q000652:urine; D003919:Diabetes Insipidus / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000652:urine; D004700:Endocrine System Diseases / Q000175:diagnosis / Q000209:etiology*; D006728:Hormones / Q000097:blood; D006801:Humans; D007177:Inappropriate ADH Syndrome / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000652:urine; D008297:Male; D009994:Osmolar Concentration; D010902:Pituitary Gland / Q000293:injuries* / Q000503:physiopathology; D012964:Sodium / Q000097:blood
D006728:Hormones; D012964:Sodium