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Dilemmas in the Management of Acute TBI: A Prospective Observational Study of Anterior Pituitary Dysfunction and Its Correlation with Outcome
Abstract
Background The frequency and pattern of endocrinal abnormalities among patients with traumatic brain injury occur more frequently than previously suspected. Objective The aim of this study was to assess anterior pituitary dysfunction in patients with moderate-to-severe traumatic brain injury and outcome after treatment. Materials and Methods One hundred patients with moderate-to-severe head injury presenting within 48 hours of injury were enrolled. Blood samples of all patients were taken for the hormonal assay at second day, at 2 weeks, 1 month, 3 months, and 6 months. Patients were evaluated by Glasgow coma scale (GCS), Glasgow outcome score (GOS), and hormone profile. Results The median GCS score was 10/15. Forty-four patients were operated and 56 patients were managed medically. Seven operated patients expired; 30 patients had good recovery. In conservative group, 46 patients had good outcome and two patients died. Cortisol and thyroid hormone values were changed prominently, followed by prolactin and growth hormone. On univariate analysis, association of GOS with fT3, fT4, serum prolactin, and serum cortisol was seen. On multivariate analysis, strong correlation of GOS with f T4 values was seen (p = 0.008) Conclusion Most of the hormonal deficiency occurs in immediate phase. Hormonal screening should be done to improve long term outcome.
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“Hyperprolactinemia occurs in more than 50% of TBI survivors in the early, acute phase (Prasanna et al., 2015; Choudhary et al., 2023).”
From Acute neuroendocrine changes after traumatic brain injury (2024) · cites this paper as Choudhary et al., 2023
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Cited by
Aljboor, G. S., Tulemat, A., Al-Saedi, A. R., Radoi, M. P., Toader, C., & Papacocea, T. M. (2024) · Neurosurgical Review · doi:10.1007/s10143-024-03088-3 · Cited by 30
Acute neuroendocrine changes after traumatic brain injury
Magyar-Sumegi, Z. D., Stankovics, L., Lendvai-Emmert, D., Czigler, A., Hegedus, E., Csendes, M., Toth, L., Ungvari, Z., Buki, A., & Toth, P. (2024) · Brain and Spine · doi:10.1016/j.bas.2024.102830 · Cited by 23
Metadata
- Authors
- Choudhary, A., Sobti, S., Dev, N., Kulshreshtha, B., Sharma, R., Kaushik, K., & Kumar, A.
- Affiliations
- Department of Neurosurgery, ABVIMS and Dr. RML Hospital, New Delhi, India
- Department of Neurosurgery, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
- Department of Neurosurgery, Asian Vivekananda Hospital, Moradabad, Uttar Pradesh, India
- Department of Endocrinology, ABVIMS and Dr. RML Hospital, New Delhi, India
- Venue
- Indian Journal of Neurotrauma
- Publisher
- Georg Thieme Verlag KG
- Published
- 2023-07-13
- Volume
- 21
- Issue
- 01
- Pages
- 055-062
- ISSN
- 0973-0508
- 2213-3739
- Cited by
- 0
- References
- 8
- Language
- en
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