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CLINICAL STUDY |
Max Planck Institute of Psychiatry, Clinical Neuroendocrinology Group Kraepelinstr. 10, 80804 Munich, Germany, 1 Pfizer GmbH, Pfizerstr. 1, 76032 Karlruhe, Germany, 2 University Hospital Essen, Department of Endocrinology, Hufelandstr. 55 45122 Essen, Germany and 3 Neurologic Clinic Bad Aibling, Kolbermoorer Straße 72, 83043 Bad Aibling, Germany
(Correspondence should be addressed to G K Stalla; Email: stalla{at}mpipsykl.mpg.de)
Objective: Cross-sectional studies report a high prevalence of hypopituitarism after traumatic brain injury (TBI); however, no longitudinal studies on time of manifestation and reversibility exist. This study was conducted to assess hypopituitarism 3 and 12 months after TBI.
Design: This was a prospective, longitudinal, diagnostic study.
Methods: Seventy-eight patients (52 men, 26 women, mean age 36.0 years) with TBI grades I–III and 38 healthy subjects (25 men, 13 women, mean age 36.4 years) as a control group for the GHRH + arginine test were studied. The prevalence ofhypopituitarism was assessed 3 and 12 months after TBI by GHRH + arginine test, short adrenocorticotropic hormone (ACTH) test, and basal hormone measurements in patients.
Results: After 3 months, 56% of all patients had impairments of at least one pituitary axis with axes being affected as follows: gonadotropic 32%, corticotropic 19%, somatotropic 9% and thyrotropic 8%. After 12 months, fewer patients were affected, but in some cases new impairments occurred; 36% still had impairments. The axes were affected as follows after 12 months: gonadotropic 21%, somatotropic 10%, corticotropic 9% and thyrotropic 3%.
Conclusions: Hypopituitarism occurs often in the post-acute phase after TBI and may normalize later, but may also develop after the post-acute phase of TBI.
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H J Schneider, B L Herrmann, M Schneider, C Sievers, L Schaaf, and G K Stalla Discrepant results in the diagnosis of GH deficiency with the insulin-tolerance test and the GHRH plus arginine test in patients with traumatic brain injury. Eur. J. Endocrinol., October 1, 2006; 155(4): 553 - 557. [Abstract] [Full Text] [PDF]
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H J Schneider, S Rovere, G Corneli, C G Croce, V Gasco, R Ruda, S Grottoli, G K Stalla, R Soffietti, E Ghigo, et al. Endocrine dysfunction in patients operated on for non-pituitary intracranial tumors. Eur. J. Endocrinol., October 1, 2006; 155(4): 559 - 566. [Abstract] [Full Text] [PDF]
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