Cited by 289Traumatic Brain Injury ResearchTraumatic Brain Injury and Neurovascular DisturbancesPituitary Gland Disorders and Treatments

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Prevalence of Neuroendocrine Dysfunction in Patients Recovering from Traumatic Brain Injury

Lieberman, S. A.·2001·Journal of Clinical Endocrinology & Metabolism

DOI 10.1210/jc.86.6.2752

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Abstract

Although hypopituitarism is a known complication of head injury, it may be underrecognized due to its subtle clinical manifestations. The nonspecific symptoms may be masked by and may contribute to the physical and psychological sequelae of brain trauma. This study examines the prevalence of neuroendocrine abnormalities in patients rehabilitating from traumatic brain injury. Seventy adults (mean age, 31.5 +/- 1.1 yr; range, 18--58; 46 men and 24 women) with traumatic brain injury an average of 49 +/- 8 months before the study (median, 13 months) underwent a series of standard endocrine tests, including serum levels of TSH, free T(4), insulin-like growth factor I, PRL, testosterone (males), and cosyntropin stimulation. Abnormal results of these tests were followed by dynamic tests of gonadotropin, TSH, and GH secretion. Glucagon stimulation testing in 48 subjects revealed GH deficiency (peak, <3 microg/L) in 14.6%. Free T(4) (n = 6; 8.6%), TSH (n = 7; 10%), or both (n = 2; 2.9%) were low in 21.7%, whereas 87% had both TSH and free T(4) below the midnormal level. Basal morning cortisol was below normal in 45.7% of subjects, whereas cosyntropin-stimulated levels were insufficient (peak, <500 nmol/L) in 7.1%. Hypogonadism and hyperprolactinemia were uncommon. In summary, pituitary hormone deficiencies were identified in a substantial proportion of patients with previous brain injury. GH deficiency, found in 15% by glucagon stimulation testing, may compound the physical and psychological complications of traumatic brain injury and interfere with rehabilitation.

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Authors: Lieberman, S. A.
Corresponding author: Lieberman, S. A.
Venue: Journal of Clinical Endocrinology & Metabolism
Publisher: The Endocrine Society
Published: 2001-06-01
Volume: 86
Issue: 6
Pages: 2752-2756
ISSN: 0021-972X (ISSN-L)
DOI: 10.1210/jc.86.6.2752
OpenAlex: W4246438689
Cited by: 261
References: 0
Citations by year: 2026: 1 · 2025: 2 · 2024: 5 · 2023: 3 · 2022: 5 · 2021: 13 · 2020: 7 · 2019: 7 · 2018: 12 · 2017: 11 · 2016: 7 · 2015: 14 · 2014: 10 · 2013: 11 · 2012: 18
FWCI: 3.50
Type: journal article
Language: en
Open access: closed
Locations: The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
Topics: Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury Research
Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury and Neurovascular Disturbances
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
Keywords: neuroendocrine dysfunction, traumatic brain injury, recovery, prevalence, hypothalamic-pituitary-adrenal axis, endocrine disorders

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Prevalence of Neuroendocrine Dysfunction in Patients Recovering from Traumatic Brain Injury

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