Document Detail


Residual pituitary function after brain injury-induced hypopituitarism: a prospective 12-month study.
MedLine Citation:
PMID:  16144947     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
CONTEXT: Traumatic brain injury (TBI) and subarachnoid hemorrhage (SAH) are conditions at high risk for the development of hypopituitarism. OBJECTIVE: The objective of the study was to clarify whether pituitary deficiencies and normal pituitary function recorded at 3 months would improve or worsen at 12 months after the brain injury. DESIGN AND PATIENTS: Pituitary function was tested at 3 and 12 months in patients who had TBI (n = 70) or SAH (n = 32). RESULTS: In TBI, the 3-month evaluation had shown hypopituitarism (H) in 32.8%. Panhypopituitarism (PH), multiple (MH), and isolated (IH) hypopituitarism had been demonstrated in 5.7, 5.7, and 21.4%, respectively. The retesting demonstrated some degree of H in 22.7%. PH, MH, and IH were present in 5.7, 4.2, and 12.8%, respectively. PH was always confirmed at 12 months, whereas MH and IH were confirmed in 25% only. In 5.5% of TBI with no deficit at 3 months, IH was recorded at retesting. In 13.3% of TBI with IH at 3 months, MH was demonstrated at 12-month retesting. In SAH, the 3-month evaluation had shown H in 46.8%. MH and IH had been demonstrated in 6.2 and 40.6%, respectively. The retesting demonstrated H in 37.5%. MH and IH were present in 6.2 and 31.3%, respectively. Although no MH was confirmed at 12 months, two patients with IH at 3 months showed MH at retesting; 30.7% of SAH with IH at 3 months displayed normal pituitary function at retesting. In SAH, normal pituitary function was always confirmed. In TBI and SAH, the most common deficit was always severe GH deficiency. CONCLUSION: There is high risk for H in TBI and SAH patients. Early diagnosis of PH is always confirmed in the long term. Pituitary function in brain-injured patients may improve over time but, although rarely, may also worsen. Thus, brain-injured patients must undergo neuroendocrine follow-up over time.
Authors:
Gianluca Aimaretti; Maria Rosaria Ambrosio; Carolina Di Somma; Maurizio Gasperi; Salvatore Cannavò; Carla Scaroni; Alessandra Fusco; Patrizia Del Monte; Ernesto De Menis; Marco Faustini-Fustini; Franco Grimaldi; Francesco Logoluso; Paola Razzore; Silvia Rovere; Salvatore Benvenga; Ettore Ciro Degli Uberti; Laura De Marinis; Gaetano Lombardi; Franco Mantero; Enio Martino; Giulio Giordano; Ezio Ghigo
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2005-09-06
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  90     ISSN:  0021-972X     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-11-08     Completed Date:  2005-12-02     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:  6085-92     Citation Subset:  AIM; IM    
Affiliation:
Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Turin, C.so Dogliotti, 14, 10126 Turin, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adult
Brain Injuries / complications*
Diabetes Insipidus / etiology
Female
Human Growth Hormone / deficiency
Humans
Hypopituitarism / physiopathology*
Male
Pituitary Gland / physiopathology*
Prospective Studies
Subarachnoid Hemorrhage / physiopathology*
Chemical
Reg. No./Substance:
12629-01-5/Human Growth Hormone

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


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