title: Residual pituitary function after brain injury-induced hypopituitarism: a prospective 12-month study.
abstract: BACKGROUND
  Traumatic brain injury (TBI) and subarachnoid hemorrhage (SAH) are conditions at high risk for the development of hypopituitarism.
  
  
  OBJECTIVE
  The objective of the study was to clarify whether pituitary deficiencies and normal pituitary function recorded at 3 months would improve or worsen at 12 months after the brain injury.
  
  
  METHODS
  Pituitary function was tested at 3 and 12 months in patients who had TBI (n = 70) or SAH (n = 32).
  
  
  RESULTS
  In TBI, the 3-month evaluation had shown hypopituitarism (H) in 32.8%. Panhypopituitarism (PH), multiple (MH), and isolated (IH) hypopituitarism had been demonstrated in 5.7, 5.7, and 21.4%, respectively. The retesting demonstrated some degree of H in 22.7%. PH, MH, and IH were present in 5.7, 4.2, and 12.8%, respectively. PH was always confirmed at 12 months, whereas MH and IH were confirmed in 25% only. In 5.5% of TBI with no deficit at 3 months, IH was recorded at retesting. In 13.3% of TBI with IH at 3 months, MH was demonstrated at 12-month retesting. In SAH, the 3-month evaluation had shown H in 46.8%. MH and IH had been demonstrated in 6.2 and 40.6%, respectively. The retesting demonstrated H in 37.5%. MH and IH were present in 6.2 and 31.3%, respectively. Although no MH was confirmed at 12 months, two patients with IH at 3 months showed MH at retesting; 30.7% of SAH with IH at 3 months displayed normal pituitary function at retesting. In SAH, normal pituitary function was always confirmed. In TBI and SAH, the most common deficit was always severe GH deficiency.
  
  
  CONCLUSIONS
  There is high risk for H in TBI and SAH patients. Early diagnosis of PH is always confirmed in the long term. Pituitary function in brain-injured patients may improve over time but, although rarely, may also worsen. Thus, brain-injured patients must undergo neuroendocrine follow-up over time.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Turin, C.so Dogliotti, 14, 10126 Turin, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Aimaretti
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: Ambrosio
authors.forename: Carolina
authors.initials: C
authors.lastname: Di Somma
authors.forename: Maurizio
authors.initials: M
authors.lastname: Gasperi
authors.forename: Salvatore
authors.initials: S
authors.lastname: Cannavò
authors.forename: Carla
authors.initials: C
authors.lastname: Scaroni
authors.forename: Alessandra
authors.initials: A
authors.lastname: Fusco
authors.forename: Patrizia
authors.initials: P
authors.lastname: Del Monte
authors.forename: Ernesto
authors.initials: E
authors.lastname: De Menis
authors.forename: Marco
authors.initials: M
authors.lastname: Faustini-Fustini
authors.forename: Franco
authors.initials: F
authors.lastname: Grimaldi
authors.forename: Francesco
authors.initials: F
authors.lastname: Logoluso
authors.forename: Paola
authors.initials: P
authors.lastname: Razzore
authors.forename: Silvia
authors.initials: S
authors.lastname: Rovere
authors.forename: Salvatore
authors.initials: S
authors.lastname: Benvenga
authors.forename: Ettore Ciro
authors.initials: EC
authors.lastname: Degli Uberti
authors.forename: Laura
authors.initials: L
authors.lastname: De Marinis
authors.forename: Gaetano
authors.initials: G
authors.lastname: Lombardi
authors.forename: Franco
authors.initials: F
authors.lastname: Mantero
authors.forename: Enio
authors.initials: E
authors.lastname: Martino
authors.forename: Giulio
authors.initials: G
authors.lastname: Giordano
authors.forename: Ezio
authors.initials: E
authors.lastname: Ghigo
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000150:complications*; D003919:Diabetes Insipidus / Q000209:etiology; D005260:Female; D019382:Human Growth Hormone / Q000172:deficiency; D006801:Humans; D007018:Hypopituitarism / Q000503:physiopathology*; D008297:Male; D010902:Pituitary Gland / Q000503:physiopathology*; D011446:Prospective Studies; D013345:Subarachnoid Hemorrhage / Q000503:physiopathology*
chemical_list: D019382:Human Growth Hormone