title: Prospective investigation of anterior pituitary function in the acute phase and 12 months after pediatric traumatic brain injury.
abstract: OBJECTIVE
  Although head trauma is common in childhood, there is no enough prospective study investigating both acute phase and 12 months after injury. Therefore, a prospective clinical trial was planned to evaluate the pituitary function in childhood in the acute and chronic phase after traumatic brain injury (TBI).
  
  
  METHODS
  Forty-one children (27 boys and 14 girls, mean age 7 ± 4.3), who were admitted to neurosurgery intensive care unit due to head trauma, were included. Twenty-one (51.2 %) patients had mild, 10 (24.4 %) had moderate, and 10 (24.4 %) had severe TBI. Twenty-two of them were reevaluated 12 months after TBI. Basal pituitary hormone levels were measured during acute (first 24 h) and chronic phase of TBI. Additionally, in the chronic phase, GHRH-arginine test was used for the diagnosis of growth hormone (GH) deficiency.
  
  
  RESULTS
  In the acute phase, 10 patients (24.4 %) had ACTH deficiency, and the overall 44.3 % of patients had at least one pituitary hormone dysfunction. All the pituitary hormone deficiencies during the acute phase were recovered after 12 months. Two patients (9.1 %) had new-onset GH deficiency in the chronic phase, and in one of them, ACTH deficiency was also present.
  
  
  CONCLUSIONS
  Present prospective data clearly demonstrated that most of the hormonal changes in the early acute phase were transient, suggesting an adaptive response, and these changes did not predict the hormone deficiencies after 1 year. In the chronic phase, although GH deficiency was present, the frequency of TBI-induced hypopituitarism was clearly lower than the adult patients.
authors: Department of Neurosurgery, Erciyes University Medical School, Kayseri, Turkey.
authors: Halil
authors: H
authors: Ulutabanca
authors: Nihal
authors: N
authors: Hatipoglu
authors: Fatih
authors: F
authors: Tanriverdi
authors: Abdülkerim
authors: A
authors: Gökoglu
authors: Mehmet
authors: M
authors: Keskin
authors: Ahmet
authors: A
authors: Selcuklu
authors: Selim
authors: S
authors: Kurtoglu
authors: Fahrettin
authors: F
authors: Kelestimur
mesh_terms: D000208:Acute Disease; D000324:Adrenocorticotropic Hormone / Q000172:deficiency; D000886:Anthropometry; D001930:Brain Injuries / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015592:Immunoradiometric Assay; D008297:Male; D010900:Pituitary Diseases / Q000097:blood* / Q000209:etiology*; D010908:Pituitary Hormones, Anterior / Q000097:blood*; D011446:Prospective Studies; D018709:Statistics, Nonparametric
chemical_list: D010908:Pituitary Hormones, Anterior; D000324:Adrenocorticotropic Hormone