title: Neuroendocrine Disturbances One to Five or More Years after Traumatic Brain Injury and Aneurysmal Subarachnoid Hemorrhage: Data from the German Database on Hypopituitarism.
abstract: Neuroendocrine disturbances are common after traumatic brain injury (TBI) and aneurysmal subarachnoid hemorrhage (SAH), but only a few data exist on long-term anterior pituitary deficiencies after brain injury. We present data from the Structured Data Assessment of Hypopituitarism after TBI and SAH, a multi-center study including 1242 patients. We studied a subgroup of 351 patients, who had sustained a TBI (245) or SAH (106) at least 1 year before endocrine assessment (range 1-55 years) in a separate analysis. The highest prevalence of neuroendocrine disorders was observed 1-2 years post-injury, and it decreased over time only to show another maximum in the long-term phase in patients with brain injury occurring ≥5 years prior to assessment. Gonadotropic and somatotropic insufficiencies were most common. In the subgroup from 1 to 2 years after brain injury (n = 126), gonadotropic insufficiency was the most common hormonal disturbance (19%, 12/63 men) followed by somatotropic insufficiency (11.5%, 7/61), corticotropic insufficiency (9.2%, 11/119), and thyrotropic insufficiency (3.3%, 4/122). In patients observed ≥ 5 years after brain injury, the prevalence of somatotropic insufficiency increased over time to 24.1%, whereas corticotropic and thyrotrophic insufficiency became less frequent (2.5% and 0%, respectively). The prevalence differed regarding the diagnostic criteria (laboratory values vs. physician`s diagnosis vs. stimulation tests). Our data showed that neuroendocrine disturbances are frequent even years after TBI or SAH, in a cohort of patients who are still on medical treatment.
authors.affiliation: 1 Schön Klinik Bad Aibling , Bad Aibling, Germany .
authors.forename: Carmen
authors.initials: C
authors.lastname: Krewer
authors.affiliation: 1 Schön Klinik Bad Aibling , Bad Aibling, Germany .
authors.forename: Manfred
authors.initials: M
authors.lastname: Schneider
authors.affiliation: 2 University Hospital Innenstadt, Ludwig-Maximilians-University , Munich, Germany .
authors.forename: Harald Jörn
authors.initials: HJ
authors.lastname: Schneider
authors.affiliation: 3 Department of Neurosurgery, University of Duisburg-Essen , Essen, Germany .
authors.forename: Ilonka
authors.initials: I
authors.lastname: Kreitschmann-Andermahr
authors.affiliation: 4 Department of Neurosurgery, University of Erlangen-Nürnberg , Erlangen, Germany .
authors.forename: Michael
authors.initials: M
authors.lastname: Buchfelder
authors.affiliation: 5 Center of Endocrinology, Diabetes, and Preventive Medicine, University Hospital Cologne , Cologne, Germany .
authors.forename: Michael
authors.initials: M
authors.lastname: Faust
authors.affiliation: 6 Department of Internal Medicine, Evangelical Hospital Mettmann , Mettmann, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Berg
authors.affiliation: 7 Specialized Medical Practice for Diabetes and Hormonal Disorders , Erfurt, Germany .
authors.forename: Henri
authors.initials: H
authors.lastname: Wallaschofski
authors.affiliation: 8 NRZ Neurological Rehabilitation Center, University of Leipzig , Leipzig, Germany .
authors.forename: Caroline
authors.initials: C
authors.lastname: Renner
authors.affiliation: 9 Department of Neurosurgery, University Hospital Giessen , Giessen, Germany .
authors.forename: Eberhard
authors.initials: E
authors.lastname: Uhl
authors.affiliation: 1 Schön Klinik Bad Aibling , Bad Aibling, Germany .
authors.forename: Eberhard
authors.initials: E
authors.lastname: Koenig
authors.affiliation: 10 ClinSupport GmbH, Erlangen, Germany .
authors.forename: Martina
authors.initials: M
authors.lastname: Jordan
authors.affiliation: 11 Clinical Neuroendocrinology Group, Max Planck Institute of Psychiatry , Munich, Germany .
authors.forename: Günter Karl
authors.initials: GK
authors.lastname: Stalla
authors.affiliation: 11 Clinical Neuroendocrinology Group, Max Planck Institute of Psychiatry , Munich, Germany .
authors.forename: Anna
authors.initials: A
authors.lastname: Kopczak
mesh_terms: D000328:Adult; D000070642:Brain Injuries, Traumatic / Q000150:complications* / Q000453:epidemiology; D016208:Databases, Factual; D004700:Endocrine System Diseases / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007018:Hypopituitarism / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000453:epidemiology
keywords: SAH; TBI; hypopituitarism; neuroendocrinology