Assessment of patterns of pituitary dysfunction after severe traumatic brain injury

Abstract

Background: Chronic posttraumatic brain injury (TBI) pituitary dysfunction is not a novel concept; nonetheless, it has become increasingly common as a result of increased exposure to its causes, namely traffic accidents, sports-related injuries, falls, and injuries sustained during conflicts. The goal of this study was to identify patterns of pituitary dysfunction following severe traumatic brain injury. Methodology: A cross‑sectional study was conducted by enrolling 200 patients with TBI. Participants were patients having a history of moderate‑to‑severe TBI at least 3 months before enrolment. Pituitary function test was done for all patients to determine the frequency of pituitary dysfunction, the number of axes deficiencies, and which hormone is mostly affected. Results: 122 patients had developed pituitary dysfunction after exposure to head trauma, while 78 had not. The most affected hormone by head trauma was the GH in 100 patients (50%), followed by the gonadal axis, TSH, and finally ACTH, 40 (20%), 21(10.5%), and 10 (5%), respectively. We can see that a single hormonal defect was the most prevalent abnormality in 87 (43.5%), followed by two‑axis defect in 9 (4.5%) and only 3 patients (1.5%) had suffered from four axes deficiencies. Conclusion: TBI pituitary dysfunction is more common than expected in the cohort investigated, with a single hormonal deficiency being the most common aberration, with the GH axis being the most impacted.