title: The impact of hypopituitarism on function and performance in subjects with recent history of traumatic brain injury and aneurysmal subarachnoid haemorrhage.
abstract: OBJECTIVE
  To correlate deficient pituitary function with life satisfaction and functional performance in subjects with a recent history of traumatic brain injury (TBI) and subarachnoid haemorrhage (SAH).
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Eighteen subjects with TBI and 16 subjects with SAH underwent pituitary hormonal and functional assessments 5-12 months following the event. Adrenal reserve was assessed with a 1 mcg cosyntropin stimulation test and growth hormone deficiency (GHD) was diagnosed by insufficient GH response to GHRH-Arginine stimulation. Assessments of life satisfaction and performance-function included the Satisfaction with Life Scale (SWLS), Craig Handicap Assessment and Reporting Technique (CHART) and the Mayo Portland Adaptability Inventory-4 (MPAI-4).
  
  
  RESULTS
  Hypopituitarism was present in 20 (58.8%) subjects, including 50% with adrenal insufficiency. Hypothyroidism correlated with worse performance on SWLS and CHART measures. GHD was associated with poorer performance on CHART and MPAI-4 scale.
  
  
  CONCLUSIONS
  In this series of subjects with history of TBI and SAH, hypothyroidism and GHD were associated with diminished life satisfaction and performance-function on multiple assessments. Further studies are necessary to determine the appropriate testing of adrenal reserve in this population and to determine the benefit of pituitary hormone replacement therapy on function following brain injury.
authors: Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
authors: Lakshmi
authors: L
authors: Srinivasan
authors: Brian
authors: B
authors: Roberts
authors: Tamara
authors: T
authors: Bushnik
authors: Jeffrey
authors: J
authors: Englander
authors: David A
authors: DA
authors: Spain
authors: Gary K
authors: GK
authors: Steinberg
authors: Li
authors: L
authors: Ren
authors: M Elizabeth
authors: ME
authors: Sandel
authors: Zahraa
authors: Z
authors: Al-Lawati
authors: Jeffrey
authors: J
authors: Teraoka
authors: Andrew R
authors: AR
authors: Hoffman
authors: Laurence
authors: L
authors: Katznelson
mesh_terms: D000293:Adolescent; D000309:Adrenal Insufficiency / Q000209:etiology / Q000503:physiopathology / Q000523:psychology*; D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000503:physiopathology / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007018:Hypopituitarism / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011788:Quality of Life / Q000523:psychology*; D013345:Subarachnoid Hemorrhage / Q000503:physiopathology / Q000523:psychology*; D055815:Young Adult