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 cause s of traumatic brain injuries. Consequently, they may lead to perma...

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Main Authors: Aleksandra Gilis-Januszewska, Łukasz Kluczyński, Alicja Hubalewska-Dydejczyk
Format: Article
Language:English
Published: Bioscientifica 2020-05-01
Series:Endocrine Connections
Subjects:
Online Access:https://ec.bioscientifica.com/view/journals/ec/9/5/EC-20-0117.xml
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author Aleksandra Gilis-Januszewska
Łukasz Kluczyński
Alicja Hubalewska-Dydejczyk
author_facet Aleksandra Gilis-Januszewska
Łukasz Kluczyński
Alicja Hubalewska-Dydejczyk
author_sort Aleksandra Gilis-Januszewska
collection DOAJ
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 cause s of traumatic brain injuries. Consequently, they may lead to permanent or transient pituitary insufficiency that causes adverse changes in body composition, worrisome meta bolic function, reduced bone density, and a significant decrease in one’s quality of lif e. The prevalence of post-traumatic hypopituitarism is difficult to determine, and the exac t mechanisms lying behind it remain unclear. Several probable hypotheses have been sugges ted. The diagnosis of pituitary dysfunction is very challenging both due to the commo n 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. Insufficienc y of somatotropic axis is the most common abnormality, followed by presence of hypogonadi sm, hypothyroidism, hypocortisolism, and diabetes insipidus. The purpose of this re view is to summarize the current state of knowledge about post-traumatic hypopituita rism. Moreover, based on available data and on our own clinical experience, we sugges t 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.
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spelling doaj.art-2150df5d3bb4415392e535eef70fad642022-12-22T00:06:20ZengBioscientificaEndocrine Connections2049-36142049-36142020-05-0195R112R123https://doi.org/10.1530/EC-20-0117Traumatic brain injuries induced pituitary dysfunction: a call for algorithmsAleksandra Gilis-Januszewska0Łukasz Kluczyński1Alicja Hubalewska-Dydejczyk2Chair and Department of Endocrinology, Jagiellonian University Medical College, Krakow, Poland; Endocrinology Department, University Hospital in Krakow, Krakow, PolandChair and Department of Endocrinology, Jagiellonian University Medical College, Krakow, Poland; Endocrinology Department, University Hospital in Krakow, Krakow, PolandChair and Department of Endocrinology, Jagiellonian University Medical College, Krakow, Poland; Endocrinology Department, University Hospital in Krakow, Krakow, PolandTraumatic 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 cause s of traumatic brain injuries. Consequently, they may lead to permanent or transient pituitary insufficiency that causes adverse changes in body composition, worrisome meta bolic function, reduced bone density, and a significant decrease in one’s quality of lif e. The prevalence of post-traumatic hypopituitarism is difficult to determine, and the exac t mechanisms lying behind it remain unclear. Several probable hypotheses have been sugges ted. The diagnosis of pituitary dysfunction is very challenging both due to the commo n 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. Insufficienc y of somatotropic axis is the most common abnormality, followed by presence of hypogonadi sm, hypothyroidism, hypocortisolism, and diabetes insipidus. The purpose of this re view is to summarize the current state of knowledge about post-traumatic hypopituita rism. Moreover, based on available data and on our own clinical experience, we sugges t 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.https://ec.bioscientifica.com/view/journals/ec/9/5/EC-20-0117.xmlpost-traumatic hypopituitarismpituitary dysfunctiontraumatic brain injurypituitary insufficiency
spellingShingle Aleksandra Gilis-Januszewska
Łukasz Kluczyński
Alicja Hubalewska-Dydejczyk
Traumatic brain injuries induced pituitary dysfunction: a call for algorithms
Endocrine Connections
post-traumatic hypopituitarism
pituitary dysfunction
traumatic brain injury
pituitary insufficiency
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 post-traumatic hypopituitarism
pituitary dysfunction
traumatic brain injury
pituitary insufficiency
url https://ec.bioscientifica.com/view/journals/ec/9/5/EC-20-0117.xml
work_keys_str_mv AT aleksandragilisjanuszewska traumaticbraininjuriesinducedpituitarydysfunctionacallforalgorithms
AT łukaszkluczynski traumaticbraininjuriesinducedpituitarydysfunctionacallforalgorithms
AT alicjahubalewskadydejczyk traumaticbraininjuriesinducedpituitarydysfunctionacallforalgorithms