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Traumatic brain injuries induced pituitary dysfunction: a call for algorithms
Traumatic brain injury affects many people each year, resulting in a serious burden of devastating health consequences. Motor-vehicle and work-related accidents, falls, assaults, as well as sport activities are the most common causes of traumatic brain injuries. Consequently, they may lead to perman...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Bioscientifica Ltd
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7274553/ https://www.ncbi.nlm.nih.gov/pubmed/32412425 http://dx.doi.org/10.1530/EC-20-0117 |
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author | Gilis-Januszewska, Aleksandra Kluczyński, Łukasz Hubalewska-Dydejczyk, Alicja |
author_facet | Gilis-Januszewska, Aleksandra Kluczyński, Łukasz Hubalewska-Dydejczyk, Alicja |
author_sort | Gilis-Januszewska, Aleksandra |
collection | PubMed |
description | Traumatic brain injury affects many people each year, resulting in a serious burden of devastating health consequences. Motor-vehicle and work-related accidents, falls, assaults, as well as sport activities are the most common causes of traumatic brain injuries. Consequently, they may lead to permanent or transient pituitary insufficiency that causes adverse changes in body composition, worrisome metabolic function, reduced bone density, and a significant decrease in one’s quality of life. The prevalence of post-traumatic hypopituitarism is difficult to determine, and the exact mechanisms lying behind it remain unclear. Several probable hypotheses have been suggested. The diagnosis of pituitary dysfunction is very challenging both due to the common occurrence of brain injuries, the subtle character of clinical manifestations, the variable course of the disease, as well as the lack of proper diagnostic algorithms. Insufficiency of somatotropic axis is the most common abnormality, followed by presence of hypogonadism, hypothyroidism, hypocortisolism, and diabetes insipidus. The purpose of this review is to summarize the current state of knowledge about post-traumatic hypopituitarism. Moreover, based on available data and on our own clinical experience, we suggest an algorithm for the evaluation of post-traumatic hypopituitarism. In addition, well-designed studies are needed to further investigate the pathophysiology, epidemiology, and timing of pituitary dysfunction after a traumatic brain injury with the purpose of establishing appropriate standards of care. |
format | Online Article Text |
id | pubmed-7274553 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Bioscientifica Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-72745532020-06-10 Traumatic brain injuries induced pituitary dysfunction: a call for algorithms Gilis-Januszewska, Aleksandra Kluczyński, Łukasz Hubalewska-Dydejczyk, Alicja Endocr Connect Review Traumatic brain injury affects many people each year, resulting in a serious burden of devastating health consequences. Motor-vehicle and work-related accidents, falls, assaults, as well as sport activities are the most common causes of traumatic brain injuries. Consequently, they may lead to permanent or transient pituitary insufficiency that causes adverse changes in body composition, worrisome metabolic function, reduced bone density, and a significant decrease in one’s quality of life. The prevalence of post-traumatic hypopituitarism is difficult to determine, and the exact mechanisms lying behind it remain unclear. Several probable hypotheses have been suggested. The diagnosis of pituitary dysfunction is very challenging both due to the common occurrence of brain injuries, the subtle character of clinical manifestations, the variable course of the disease, as well as the lack of proper diagnostic algorithms. Insufficiency of somatotropic axis is the most common abnormality, followed by presence of hypogonadism, hypothyroidism, hypocortisolism, and diabetes insipidus. The purpose of this review is to summarize the current state of knowledge about post-traumatic hypopituitarism. Moreover, based on available data and on our own clinical experience, we suggest an algorithm for the evaluation of post-traumatic hypopituitarism. In addition, well-designed studies are needed to further investigate the pathophysiology, epidemiology, and timing of pituitary dysfunction after a traumatic brain injury with the purpose of establishing appropriate standards of care. Bioscientifica Ltd 2020-04-21 /pmc/articles/PMC7274553/ /pubmed/32412425 http://dx.doi.org/10.1530/EC-20-0117 Text en © 2020 The authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/) . |
spellingShingle | Review Gilis-Januszewska, Aleksandra Kluczyński, Łukasz Hubalewska-Dydejczyk, Alicja Traumatic brain injuries induced pituitary dysfunction: a call for algorithms |
title | Traumatic brain injuries induced pituitary dysfunction: a call for algorithms |
title_full | Traumatic brain injuries induced pituitary dysfunction: a call for algorithms |
title_fullStr | Traumatic brain injuries induced pituitary dysfunction: a call for algorithms |
title_full_unstemmed | Traumatic brain injuries induced pituitary dysfunction: a call for algorithms |
title_short | Traumatic brain injuries induced pituitary dysfunction: a call for algorithms |
title_sort | traumatic brain injuries induced pituitary dysfunction: a call for algorithms |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7274553/ https://www.ncbi.nlm.nih.gov/pubmed/32412425 http://dx.doi.org/10.1530/EC-20-0117 |
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