Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2006) 11 P639

ECE2006 Poster Presentations Neuroendocrinology and behaviour (70 abstracts)

Anterior pituitary hormone dysfunction after traumatic brain injury: less common than previously thought?

N Karavitaki 1 , JD Henderson-Slater 2 , DT Wade 2 & JAH Wass 1


1Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford, United Kingdom; 2Oxford Centre for Enablement, Nuffield Orthopaedic Centre, Oxford, United Kingdom.


Background: Traumatic brain injury (TBI) is a cause of hypopituitarism. Previous reports suggest complete or partial pituitary dysfunction in up to 40% of subjects.

Aim: To investigate the presence of anterior pituitary hormone deficits in TBI patients tested at least 3 months after the injury.

Patients and methods: The patients were recruited from those who have been assessed by the local Rehabilitation Centre over the last 5 years. The endocrine evaluation included short synacthen test, serum FSH, LH, testosterone, oestradiol/menstrual history, TSH, freeT3, freeT4, prolactin, IGF-I and glucagon test. Subjects with peak GH<6 mU/l on glucagon test were further assessed by GHRH+arginine test and were diagnosed as GH deficient if the peak GH was<18 mU/l. The cortisol response was considered adequate if >580 nmol/l on stimulatory tests.

Results: 29 subjects consented to take part [24/5 males/females, median age 46 years (range 19–65.5), median BMI 24 Kg/m2 (range 19.6–37)]. The median interval since the TBI [median GCS on admission 5 (range 3–15)] was 35 months (range 3–276). All but four had post-traumatic amnesia of at least 1 week. No patient had FSH/LH or TSH deficiency. Prolactin was normal in all cases. ACTH deficiency was diagnosed in one subject (3.5%), which proved to be transient (diagnosis 4 months and recovery 9 months following TBI). Peak GH<10 mU/l on glucagon test was found in 3 cases (10.3%). Severe GH deficiency was found in one patient (3.4%) (peak GH 3.8 and 17.8 mU/l on glucagon and GHRH+arginine tests, respectively), who however, 3 years following a minor TBI suffered intracerebral haemorrhage.

Conclusions: In this series of patients with TBI tested at least 3 months after head trauma, anterior hypopituitarism was rare. Using strict criteria, it is possible that other series have overestimated the frequency of pituitary dysfunction after TBI.

Volume 11

8th European Congress of Endocrinology incorporating the British Endocrine Societies

European Society of Endocrinology 
British Endocrine Societies 

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