Cited by 53Pituitary Gland Disorders and TreatmentsAdrenal Hormones and DisordersElectrolyte and hormonal disorders

Management OF endocrine disease: neuroendocrine surveillance and management of neurosurgical patients

Garrahy, Aoife, Sherlock, Mark, Thompson, Christopher J·2017·European Journal of Endocrinology

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.

Integrity signals

Registry

Crossref · 10.1530/eje-16-0962

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130 of 130 references verified0 citation errors · 0 not checkable

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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
Published
2017-05
Volume
176
Issue
5
Pages
R217-R233
ISSN
  • 0804-4643 (ISSN-L)
  • 1479-683X
OpenAlex
W2588832752
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

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