Document Detail

Posterior pituitary dysfunction after traumatic brain injury.
MedLine Citation:
PMID:  15579748     Owner:  NLM     Status:  MEDLINE    
Disorders of water balance are well recognized after traumatic brain injury (TBI), but there are no reliable data on their true prevalence in post-TBI patients. We aimed to evaluate the prevalence of posterior pituitary dysfunction in a large cohort of survivors of TBI. One hundred two consecutive patients (85 males) who suffered severe or moderate TBI were evaluated for diabetes insipidus (DI) at a median of 17 months (range 6-36 months) after the event, using the 8-h water deprivation test (WDT). Their results were compared against normative data obtained from 27 matched, healthy controls. Patients' medical records were retrospectively reviewed for the presence of abnormalities of salt and water balance in the immediate post-TBI period. Twenty-two patients (21.6%) developed DI in the immediate post-TBI period (acute DI group), of whom five had abnormal WDT on later testing. In total, seven patients (6.9%) had abnormal WDT (permanent DI group), five of whom had partial DI. Patients in the acute and permanent DI groups were more likely to have more severe TBI, compared with the rest of the cohort (P < 0.05). In the immediate post-TBI period, 13 patients (12.9%) had syndrome of inappropriate secretion of antidiuretic hormone, which persisted in one patient, and one other patient developed cerebral salt wasting. Diabetes insipidus and syndrome of inappropriate secretion of antidiuretic hormone were common in the immediate post-TBI period. Permanent DI was present in 6.9% of patients who survived severe or moderate TBI, which is higher than traditionally thought. Identification of patients with partial posttraumatic DI is important because appropriate treatment may reduce morbidity and optimize the potential for recovery.
Amar Agha; Evan Thornton; Patrick O'Kelly; William Tormey; Jack Phillips; Christopher J Thompson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  89     ISSN:  0021-972X     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2004 Dec 
Date Detail:
Created Date:  2004-12-06     Completed Date:  2005-02-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  5987-92     Citation Subset:  AIM; IM    
Academic Department of Endocrinology, Beaumont Hospital, Dublin 9, Ireland.
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MeSH Terms
Acute Disease
Brain Injuries / complications*,  physiopathology
Chronic Disease
Cohort Studies
Diabetes Insipidus / diagnosis,  epidemiology,  etiology*
Hydrocephalus / complications,  etiology
Hyponatremia / epidemiology,  etiology
Inappropriate ADH Syndrome / epidemiology,  etiology*
Middle Aged
Severity of Illness Index
Time Factors
Water Deprivation

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

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