Chronic endocrine consequences of traumatic brain injury: what is the evidence?

TY - JOUR

T1 - Chronic endocrine consequences of traumatic brain injury

T2 - what is the evidence?

AU - Klose, Marianne

AU - Feldt-Rasmussen, Ulla

PY - 2018

Y1 - 2018

N2 - Traumatic brain injury (TBI) is a major public health problem with potentially debilitating consequences for the individual. Hypopituitarism after TBI has received increasing attention over the past decade; development of the condition as a consequence of TBI was previously hardly mentioned in textbooks on the subject. Hypopituitarism has been reported in more than 25% of patients with TBI and is now thought to be one of the most important causes of treatable morbidity in TBI survivors. However, most clinicians dealing with neuroendocrine diseases and TBI generally do not see such a high incidence of hypopituitarism. This disproportion is not clearly explained, but recent data indicate that diagnostic testing, which is designed for high-risk populations and not for a cohort of patients with, for example, de novo isolated growth hormone deficiency (the predominant finding in TBI), might have overestimated the true risk and disease burden of hypopituitarism. In this Opinion article, we discuss current recommendations for post-traumatic hypopituitarism in light of recent evidence.

AB - Traumatic brain injury (TBI) is a major public health problem with potentially debilitating consequences for the individual. Hypopituitarism after TBI has received increasing attention over the past decade; development of the condition as a consequence of TBI was previously hardly mentioned in textbooks on the subject. Hypopituitarism has been reported in more than 25% of patients with TBI and is now thought to be one of the most important causes of treatable morbidity in TBI survivors. However, most clinicians dealing with neuroendocrine diseases and TBI generally do not see such a high incidence of hypopituitarism. This disproportion is not clearly explained, but recent data indicate that diagnostic testing, which is designed for high-risk populations and not for a cohort of patients with, for example, de novo isolated growth hormone deficiency (the predominant finding in TBI), might have overestimated the true risk and disease burden of hypopituitarism. In this Opinion article, we discuss current recommendations for post-traumatic hypopituitarism in light of recent evidence.

KW - Animals

KW - Brain Injuries, Traumatic/diagnosis

KW - Humans

KW - Hypopituitarism/diagnosis

KW - Neuroendocrine Cells/metabolism

U2 - 10.1038/nrendo.2017.103

DO - 10.1038/nrendo.2017.103

M3 - Comment/debate

C2 - 28885623

SN - 1759-5029

VL - 14

SP - 57

EP - 62

JO - Nature Reviews Endocrinology

JF - Nature Reviews Endocrinology

ER -