Management OF endocrine disease: neuroendocrine surveillance and management of neurosurgical patients
Abstract
Advances in the management of traumatic brain injury, subarachnoid haemorrhage and intracranial tumours have led to improved survival rates and an increased focus on quality of life of survivors. Endocrine sequelae of the acute brain insult and subsequent neurosurgery, peri-operative fluid administration and/or cranial irradiation are now well described. Unrecognised acute hypopituitarism, particularly ACTH/cortisol deficiency and diabetes insipidus, can be life threatening. Although hypopituitarism may be transient, up to 30% of survivors of TBI have chronic hypopituitarism, which can diminish quality of life and hamper rehabilitation. Patients who survive SAH may also develop hypopituitarism, though it is less common than after TBI. The growth hormone axis is most frequently affected. There is also accumulating evidence that survivors of intracranial malignancy, who have required cranial irradiation, may develop hypopituitarism. The time course of the development of hormone deficits is varied, and predictors of pituitary dysfunction are unreliable. Furthermore, diagnosis of GH and ACTH deficiency require dynamic testing that can be resource intensive. Thus the surveillance and management of neuroendocrine dysfunction in neurosurgical patients poses significant logistic challenges to endocrine services. However, diagnosis and management of pituitary dysfunction can be rewarding. Appropriate hormone replacement can improve quality of life, prevent complications such as muscle atrophy, infection and osteoporosis and improve engagement with physiotherapy and rehabilitation.
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The significance of traumatic brain injury in hypopituitarism is still under debate.
“However, the significance of traumatic brain injury in hypopituitarism is still under debate (Garrahy et al., 2017;Klose and Feldt-Rasmussen, 2017).”
From The hypothalamus-pituitary-thyroid (HPT)-axis and its role in physiology and pathophysiology of other hypothalamus-pituitary functions (2021) · cites this paper as Garrahy et al., 2017
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- Authors
- Garrahy, A., Sherlock, M., & Thompson, C. J.
- Affiliations
- Royal College of Surgeons in Ireland (IE)
- Tallaght University Hospital (IE)
- Corresponding author
- Thompson, Christopher J
- Venue
- European Journal of Endocrinology
- Publisher
- Oxford University Press (OUP)
- Published
- 2017-05
- Volume
- 176
- Issue
- 5
- Pages
- R217-R233
- ISSN
- 0804-4643 (ISSN-L)
- 1479-683X
- OpenAlex
- W2588832752
- Semantic Scholar
- 5a54e6f162be2ac4a9172fbab3e6089eb6297be6
- Cited by
- 53
- References
- 131
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 8 · 2023: 4 · 2022: 9 · 2021: 7 · 2020: 7 · 2019: 3 · 2018: 6 · 2017: 3
- FWCI
- 0.76
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Electrolyte and hormonal disorders
- Keywords
- hypopituitarism, neuroendocrine dysfunction, traumatic brain injury, subarachnoid hemorrhage, intracranial tumors, cranial irradiation, growth hormone deficiency, ACTH deficiency, diabetes insipidus, hormone replacement therapy, neurosurgical patients, endocrine surveillance, quality of life
- MeSH terms
- Brain Injuries, Traumatic, Adrenocorticotropic Hormone, Brain Neoplasms, Diabetes Insipidus, Endocrine System Diseases, Fluid Therapy, Humans, Hypopituitarism, Neurosecretory Systems, Postoperative Care, Postoperative Complications, Subarachnoid Hemorrhage, Cranial Irradiation, Human Growth Hormone, Neurosurgical Procedures, Hormone Replacement Therapy
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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