Document Detail


Negative effect of hypopituitarism following brain trauma in patients with diffuse axonal injury.
MedLine Citation:
PMID:  19943735     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: The aim of this prospective observational study was to assess the incidence and pattern of hypopituitarism after diffuse axonal injury (DAI) and to identify its effect on these patients in terms of functional outcome. METHODS: Of 1307 patients with traumatic brain injury treated at the authors' institution between March 2005 and June 2008, 65 patients with DAI were enrolled in the present study. The authors determined basal hormone levels, initial Glasgow Coma Scale scores, the Marshall CT grades, the presence of abnormal signal intensity indicating lesions on MR images, and duration of unconsciousness. At the 6-month follow-up visits, functional outcomes were estimated using the Modified Barthel Index. Univariate and multivariate analyses were performed to identify factors that influenced functional outcomes. RESULTS: Twenty-one patients with hypopituitarism (Group A) had more lesions in the body of the corpus callosum, basal ganglia, thalamus, and the gray-white matter junction than those without hypopituitarism (Group B). In Group A, growth hormone deficiency (17 patients, 80.9%) was the most common, and multiple pituitary hormone deficiencies were found in 12 patients (57.1%). The mean Modified Barthel Index score at the 6-month follow-up was 64.7 in Group A and 88.5 in Group B (p = 0.027). Duration of unconsciousness (p = 0.035), the Marshall CT grade (p = 0.021), hypopituitarism (p = 0.044), and abnormal signal intensities on MR imaging in midline or deep structures of the brain (p = 0.001) were found to be associated with functional outcome. CONCLUSIONS: The findings in this prospective observational study suggest that hypopituitarism in patients with DAI has a relationship not only with injuries in the midline or deep structures of the brain, but also with a poor outcome.
Authors:
Jae Hyun Jeong; Young Zoon Kim; Yong Woon Cho; Joon Soo Kim
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  113     ISSN:  1933-0693     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-02     Completed Date:  2010-09-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  532-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurosurgery, Masan Samsung Hospital, Sungkyunkwan University School of Medicine, Masan, Korea.
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Brain / pathology,  radiography
Brain Injuries / complications*,  pathology,  therapy*
Diffuse Axonal Injury / complications*,  pathology,  therapy*
Female
Follow-Up Studies
Humans
Hypopituitarism / complications*,  pathology,  therapy*
Magnetic Resonance Imaging
Male
Middle Aged
Prospective Studies
Recovery of Function
Severity of Illness Index
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Unconsciousness
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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