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Indian Journal of Neurotrauma 2013; 10(02): 92-96
DOI: 10.1016/j.ijnt.2013.10.002
Original Article
Thieme Medical and Scientific Publishers Private Ltd.

Endocrine dysfunction following traumatic brain injury in acute stage

Arindom Kakati
a   Assistant Professor, Department of Neurosurgery, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong, Meghalaya 793018, India
,
Bhagavatula Indira Devi
b   Professor, Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka 560029, India
,
V. Bhadrinarayan
c   Professor, Department of Neuroanesthesiology and Neurocritical Care, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka 560029, India
,
Pramila Kalra
d   Associate Professor, Department of Endocrinology, M S Ramaiah Medical College Hospital, Bangalore, Karnataka 560029, India
,
Dhaval Shukla
e   Additional Professor, Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka 560029, India
› Author Affiliations
Subject Editor:
Further Information

Publication History

13 April 2013

23 October 2013

Publication Date:
06 April 2017 (online)

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Abstract

Aim

Only few studies of hormonal dysfunction in acute setting after traumatic brain injury (TBI) are available in literature with variable results. The aim of the present study was to determine the incidence of anterior pituitary hormone deficiencies, and correlate with in hospital mortality.

Methods

This study was carried out on 30 patients with moderate to severe TBI presenting within 24 h of injury. Chemiluminiscence immunoassay using an automated chemiluminiscence analyser was used to determine the basal hormone levels. Thyroid stimulating hormone (TSH), prolactin (PRL), cortisol, growth hormone (GH), and testosterone in males or luteinizing hormone (LH) and follicle stimulating hormone (FSH) in females were measured.

Results

Out of the 30 cases, 12 cases underwent surgery for various reasons. Six patients expired, and all of them had a poor GCS at presentation (mean 4.8 ± 0.9). In the acute setting high cortisol level showed a trend towards significance (p = 0.097) in terms of mortality. Other hormonal levels were also found to be abnormal, but no conclusion could be drawn due to small number.

Conclusion

Anterior pituitary hormone imbalance is common after TBI in acute setting. Elevated cortisol is associated with increased mortality.

Keywords

Traumatic brain injury - Pituitary dysfunction - Cortisol
 

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