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. 2017 Feb;40(2):193-205.
doi: 10.1007/s40618-016-0546-1. Epub 2016 Sep 26.

Pituitary function within the first year after traumatic brain injury or subarachnoid haemorrhage

A Tölli  1 , J Borg  2 , B-M Bellander  3 , F Johansson  4 , C Höybye  5   6
Affiliations

Pituitary function within the first year after traumatic brain injury or subarachnoid haemorrhage

A Tölli et al. J Endocrinol Invest. 2017 Feb.

Abstract

Purpose: 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.

Keywords: Hormone disturbance; Pituitary; Subarachnoidal haemorrhage; Traumatic brain injury.

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Conflict of interest statement

The authors have no competing interests to declare. Ethical approval The study was approved by Regional Ethical Review Board in Stockholm (No: 2008/3:9 2008/1574-31/3). Informed Consent Our research involved human participants who had obtained informed consent.

Figures

Fig. 1
Fig. 1
Flowchart of blood samples
Fig. 2
Fig. 2
Flowchart of study participants
Fig. 3
Fig. 3
Numbers of patients with pituitary deficiency after TBI at baseline and 3, 6 and 12 months follow-up
Fig. 4
Fig. 4
Numbers of patients with pituitary deficiency after SAH at baseline and 3, 6 and 12 months follow-up
See this image and copyright information in PMC

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