title: Neuroendocrine dysfunction in acute phase of moderate-to-severe traumatic brain injury: a prospective study.
abstract: OBJECTIVE
  Most of the retrospective studies have demonstrated that traumatic brain injury mediated hypopituitarism could be more frequent than previously known. Therefore, this study has prospectively investigated pituitary function and their correlation with severity, pressure effect and Glasgow Outcome Scale in the acute phase of moderate-to-severe traumatic brain injury.
  
  
  METHODS
  One hundred consecutive moderate-to-severe traumatic brain injury patients from August 2012 to November 2013 formed the study group. Apart from clinical assessment, non-contrast computed tomography of the head was performed on all patients on admission. The hormonal analysis (fT3, fT4, TSH, GH, Cortisol, Prolactin) was performed within 24 hours of traumatic brain injury and was repeated on the 7th day amongst the patients who survived.
  
  
  RESULTS
  Growth hormone was the most common hormone to decrease. Cortisol was the most common hormone to increase. Risk of pituitary insufficiency was increased in patients with severe traumatic brain injury, patients with increased intracranial pressure and who had low Glasgow Outcome Scale.
  
  
  CONCLUSIONS
  Neuroendocrine dysfunction occurs often in the acute phase of moderate-to-severe traumatic brain injury, more commonly in patients with severe traumatic brain injury, patients with pressure effects and low Glasgow Outcome Scale. Hormonal analysis should be considered in patients with moderate-to-severe traumatic brain injury, so that appropriate hormonal replacement can be done to optimize the clinical outcome.
authors: Department of Neurosurgery, S.M.S Medical College , Jaipur , India.
authors: K L
authors: KL
authors: Prasanna
authors: R S
authors: RS
authors: Mittal
authors: Ashok
authors: A
authors: Gandhi
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000150:complications / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D023261:Glasgow Outcome Scale; D019382:Human Growth Hormone / Q000378:metabolism*; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D007018:Hypopituitarism / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology*; D019586:Intracranial Hypertension / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology*; D008297:Male; D009490:Neurosecretory Systems / Q000503:physiopathology; D010902:Pituitary Gland / Q000503:physiopathology*; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function
chemical_list: D019382:Human Growth Hormone; D006854:Hydrocortisone
keywords: Endocrine; pituitary; traumatic brain injury