Permanent central diabetes insipidus after mild traumatic brain injury.
OBJECTIVE
The patients in the permanent diabetes insipidus (DI) group are more likely to have more severe TBI, which is defined by a post-resuscitational and pre-sedational Glasgow Coma Scale (GCS) score of 8/15 or less. This study presents a case of permanent, central DI following mild traumatic brain injury with post-resuscitation GCS 13/15.


METHODS
A 17-year-old boy suffered from mild brain injury and experienced permanent DI without any anatomical changes on image in the early stage of traumatic brain injury. However, 1 year later, magnetic resonance imaging (MRI) of the brain in this patient has revealed some sequel of contusion. Moreover, the patient still has DI after treatment with diamino-8-D-arginine vasopressin (DDAVP).


CONCLUSIONS
This patient had a rare clinical presentation of permanent, central DI, following a mild traumatic brain injury. Identification of head trauma as the aetiology of hypopituitarism may be overlooked if there is a long delay in onset after trauma. Since anterior hypopituitarism can develop decades after the episode of head trauma, monitoring for endocrine dysfunction during follow-up of these patients is important.
Chou
Yi-Chun
YC
Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan, PR China.
Wang
Tzu-Yuan
TY
Yang
Pey-Yu
PY
Meng
Nai-Hsin
NH
Chou
Li-Wei
LW
D000063:Accidents, Traffic; D000293:Adolescent; D001930:Brain Injuries / Q000150:complications* / Q000175:diagnosis; D020790:Diabetes Insipidus, Neurogenic / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007018:Hypopituitarism / Q000150:complications; D008279:Magnetic Resonance Imaging; D008297:Male; D012720:Severity of Illness Index; D013997:Time Factors