Pituitary function within the first year after traumatic brain injury or subarachnoid haemorrhage.
OBJECTIVE
Reports on long-term variations in pituitary function after traumatic brain injury (TBI) and subarachnoid haemorrhage (SAH) diverge. The aim of the current study was to evaluate the prevalence and changes in pituitary function during the first year after moderate and severe TBI and SAH and to explore the relation between pituitary function and injury variables.


METHODS
Adults with moderate and severe TBI or SAH were evaluated at 10 days, 3, 6 and 12 months post-injury/illness. Demographic, clinical, radiological, laboratory, including hormonal data were collected.


RESULTS
A total of 91 adults, 56 (15 women/41 men) with TBI and 35 (27 women/8 men) with SAH were included. Perturbations in pituitary function were frequent early after the event but declined during the first year of follow-up. The most frequent deficiency was hypogonadotrope hypogonadism which was seen in approximately 25 % of the patients. Most of the variations were transient and without clinical significance. At 12 months, two patients were on replacement with hydrocortisone, four men on testosterone and one man on replacement with growth hormone. No relations were seen between hormonal levels and injury variables.


CONCLUSIONS
Perturbations in pituitary function continue to occur during the first year after TBI and SAH, but only a few patients need replacement therapy. Our study could not identify a marker of increased risk of pituitary dysfunction that could guide routine screening. However, data demonstrate the need for systematic follow-up of pituitary function after moderate or severe TBI or SAH.
Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, 182 88, Stockholm, Sweden. anna.tolli@ki.se.
A
A
Tölli
Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, 182 88, Stockholm, Sweden.
J
J
Borg
Department of Clinical Neuroscience, Section for Neurosurgery, Karolinska Institutet, Stockholm, Sweden.
B-M
BM
Bellander
Medical Library, Danderyd University Hospital, Stockholm, Sweden.
F
F
Johansson
Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.|Department of Endocrinology, Metabolism and Diabetology, Karolinska University Hospital, Stockholm, Sweden.
C
C
Höybye
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D000070642:Brain Injuries, Traumatic / Q000150:complications* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010900:Pituitary Diseases / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism; D010901:Pituitary Function Tests; D010907:Pituitary Hormones / Q000378:metabolism; D011379:Prognosis; D011446:Prospective Studies; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000503:physiopathology; D055815:Young Adult
D015415:Biomarkers; D010907:Pituitary Hormones
Hormone disturbance; Pituitary; Subarachnoidal haemorrhage; Traumatic brain injury
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