Traumatic brain injury induced neuroendocrine changes: Acute hormonal changes of anterior pituitary function
Abstract
Purpose It is estimated that approximately 69 million individuals worldwide will sustain a TBI each year, which accounts for substantial morbidity and mortality in both children and adults. TBI may lead to significant neuroendocrine changes, if the delicate pituitary is ruptured. In this review, we focus on the anterior pituitary hormonal changes in the acute post-TBI period and we present the evidence supporting the need for screening of anterior pituitary function in the early post-TBI time along with current suggestions regarding the endocrine assessment and management of these patients.Methods Original systematic articles with prospective and/or retrospective design studies of acute TBI were included, as were review articles and case series.Results Although TBI may motivate an acute increase of stress hormones, it may also generate a wide spectrum of anterior pituitary hormonal deficiencies. The frequency of post-traumatic anterior hypopituitarism (PTHP) varies according to the severity, the type of trauma, the time elapsed since injury, the study population, and the methodology used to diagnose pituitary hormone deficiency. Early neuroendocrine abnormalities may be transient, but additional late ones may also appear during the course of rehabilitation.Conclusions Acute hypocortisolism should be diagnosed and managed promptly, as it can be life-threatening, but currently there is no evidence to support treatment of acute GH, thyroid hormones or gonadotropins deficiencies. However, a more comprehensive assessment of anterior pituitary function should be undertaken both in the early and in the post-acute phase, since ongoing hormone deficiencies may adversely affect the recovery and quality of life of these patients.
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“…of TBI is complex and multifactorial, encompassing not only the primary mechanical injury but also a cascade of secondary processes, including systemic hypotension, hypoxia, intracranial hypertension, and disturbances in cerebral perfusion and metabolism, as reported in Figure 1 [7,8].”
- Authors
- Ntali, G., & Tsagarakis, S.
- Affiliations
- Evangelismos Hospital (GR)
- Corresponding author
- Tsagarakis, Stylianos
- Venue
- Pituitary
- Published
- 2019-02-12
- Volume
- 22
- Issue
- 3
- Pages
- 283-295
- ISSN
- 1386-341X (ISSN-L)
- 1573-7403
- OpenAlex
- W2911788797
- Semantic Scholar
- e31074f93aa67cf313281b3e1ac633b21c43b98a
- Cited by
- 29
- References
- 83
- Citations by year
- 2026: 1 · 2025: 8 · 2024: 6 · 2023: 2 · 2022: 1 · 2021: 7 · 2020: 1 · 2019: 3
- FWCI
- 0.46
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Pituitary (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Keywords
- traumatic brain injury, anterior pituitary function, stress hormones, pituitary hormone deficiency, growth hormone deficiency, thyroid hormone deficiency, gonadotropin deficiency, neuroendocrine changes
- MeSH terms
- Brain Injuries, Traumatic, Animals, Brain Injuries, Humans, Hypopituitarism, Pituitary Diseases, Quality of Life
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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