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Submitted on November 11, 2005
Accepted on February 28, 2006
Erciyes University Medical School, Department of Endocrinologyand Neurosurgery, Kayseri, Turkey; Department of Medicine School of Medicine and Complejo Hospitalario Universitario de Santiago, Santiago de Compostela University, Santiago de Compostela, Spain
* To whom correspondence should be addressed. E-mail: fktimur{at}erciyes.edu.tr.
Context: Recent data have demonstrated that traumatic brain injury (TBI) mediated hypopituitarism could be more frequent than previously known. However most of the previous data were obtained from retrospective studies.
Objectives: The aim of this study was to determine (a) the prevalence of anterior pituitary hormone deficiencies in the acute phase of TBI and after 12 months b) if severity of trauma correlated with basal hormone levels and c) whether initial hormone deficiencies predicted medium (?)-term hormonal status?
Design and Patients: Fifty-two TBI patients (43 men, 9 women) were included in the prospective study. Pituitary function was evaluated within 24 h of admission and after one year.
Results: 5.8% had TSH, 41.6% had gonadotrophin, 9.8% had ACTH and 20.4% had GH deficiency. At 12 months after TBI: 5.8% had TSH, 7.7% had gonadotrophin, 19.2% had ACTH and 37.7% had GH deficiency. Twenty-six patients (50.9%) had at least one anterior pituitary hormone deficiency, 21 patients (41.2%) had isolated hormone deficiencies and 5 patients (9.7%) had combined hormone deficiencies. Overall the pituitary hormone deficiencies recovered in 30 (57.7%) patients after one year, and new pituitary hormone deficiencies were present in 27 (51.9%) patients after one year.
Conclusions: GHD is the most common pituitary deficit at 12 months after TBI and 50.9% of the patients had at least one anterior pituitary hormone deficiency. Pituitary function may improve or worsen in a considerable number of patients over twelve months.
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