title: Incidence of pituitary dysfunction following traumatic brain injury: A prospective study from a regional neurosurgical centre.
abstract: Patients with traumatic brain injury (TBI) may develop pituitary dysfunction. Although, there is now increasing awareness of and investigations into such post-traumatic hypopituitarism (PTHP), the exact prevalence and incidence remain uncertain. Here, we aim to identify the incidence of PTHP in a selected population of TBI patients deemed at risk of PTHP at a regional neurosurgical centre in the UK. A total of 105 patients have been assessed in two cohorts: (i) 58 patients in serial cohort and (ii) 47 patients in cross-sectional late cohort. We found that in serial cohort, 10.3% (6/58) of TBI patients had abnormalities of the pituitary-adrenal axis in the acute phase (Day 0-7 post injury). In comparison, in cross-sectional late cohort, 21.3% (10/47) of the patients developed dysfunction in at least one of their pituitary axes at 6 months or more post-TBI, with hypogonadotrophic hypogonadism being the most common. Twenty-two patients from these two cohorts had their growth hormone assessment at 12 months or more post-TBI and 9.1% (2/22) were found to have growth hormone deficiency. Our results suggest that PTHP is a common condition amongst sufferers of TBI, and appropriate measures should be taken to detect and manage it.
authors.affiliation: a Division of Neurosurgery, Department of Clinical Neurosciences , Addenbrooke's Hospital, University of Cambridge , Cambridge , UK ;
authors.forename: Seyed Alireza
authors.initials: SA
authors.lastname: Alavi
authors.affiliation: a Division of Neurosurgery, Department of Clinical Neurosciences , Addenbrooke's Hospital, University of Cambridge , Cambridge , UK ;
authors.forename: Chin Lik
authors.initials: CL
authors.lastname: Tan
authors.affiliation: b Division of Anaesthesia, Department of Medicine , Addenbrooke's Hospital, University of Cambridge , Cambridge , UK ;
authors.forename: David K
authors.initials: DK
authors.lastname: Menon
authors.affiliation: c Department of Endocrinology , Addenbrooke's Hospital, University of Cambridge , Cambridge , UK.
authors.forename: Helen L
authors.initials: HL
authors.lastname: Simpson
authors.affiliation: a Division of Neurosurgery, Department of Clinical Neurosciences , Addenbrooke's Hospital, University of Cambridge , Cambridge , UK ;
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Hutchinson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000070642:Brain Injuries, Traumatic / Q000150:complications* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007018:Hypopituitarism / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010900:Pituitary Diseases / Q000453:epidemiology* / Q000209:etiology; D011446:Prospective Studies; D055815:Young Adult
keywords: Hypopituitarism; pituitary; trauma; traumatic brain injury