Neuroendocrine Dysfunction in Traumatic Brain Injury: Does Evaluation Improve Outcome in Acute Setting?
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 10
Abstract
Traumatic brain injury is one of the most common causes of mortality in young adults, with significant long term physical disability, behavioural and psychological deficits. Pituitary dysfunction is unrecognised in most traumatic brain injuries. Earlier it was considered to be a rare cause of hypopituitarism. In recent times, the surge in the incidence of pituitary dysfunction due to TBI is because of increased number of road traffic accidents and increased awareness on the same. The main aim of this study was to know the incidence of pituitary dysfunction due to traumatic brain injury and factors influencing the incidence and severity of dysfunction, and to correlate the pituitary dysfunction with overall outcome. We have evaluated 60 patients of traumatic brain injury who met the criteria. Hormonal evaluation was done, first-within 24 hours of hospital admission and after 1 month, 6 months and 1 year of follow up. Hypopituitarism was observed in 45% of patients of traumatic brain injury in acute phase, and the deficiency was attributed to adaptive response to the injury or as a pathological hormonal deficit. In majority of cases the dysfunction could be long lasting leads to various neuro-hormonal and psychological manifestations. Most common dysfunction appears to be gonadotropin and somatotropin deficiency, followed by cortisol and thyrotropin deficiency. Assessment of cortisol is of vital importance in acute phase, as cortisol deficiency is undetected, and can be lifesaving if supplemented.
Authors and Affiliations
Dr. N. V. S. Sunil Kumar, Dr. Uday Goutam Nookathota, Dr. Prakash Rao Gollapudi, Dr. Dhanunjaya Rao Ginjupally, Dr. Alluri Neeraja
Keywords
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