Diabetes Insipidus after Traumatic Brain Injury
Open accessAbstract
Traumatic brain injury (TBI) is a significant cause of morbidity and mortality in many age groups. Neuroendocrine dysfunction has been recognized as a consequence of TBI and consists of both anterior and posterior pituitary insufficiency; water and electrolyte abnormalities (diabetes insipidus (DI) and the syndrome of inappropriate antidiuretic hormone secretion (SIADH)) are amongst the most challenging sequelae. The acute head trauma can lead (directly or indirectly) to dysfunction of the hypothalamic neurons secreting antidiuretic hormone (ADH) or of the posterior pituitary gland causing post-traumatic DI (PTDI). PTDI is usually diagnosed in the first days after the trauma presenting with hypotonic polyuria. Frequently, the poor general status of most patients prevents adequate fluid intake to compensate the losses and severe dehydration and hypernatremia occur. Management consists of careful monitoring of fluid balance and hormonal replacement. PTDI is associated with high mortality, particularly when presenting very early following the injury. In many surviving patients, the PTDI is transient, lasting a few days to a few weeks and in a minority of cases, it is permanent requiring management similar to that offered to patients with non-traumatic central DI.
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The 'triphasic response' (transient DI followed by transient SIADH, sometimes progressing to persistent central DI) has been occasionally described after TBI.
“The 'triphasic response,' in which transient DI is followed by transient SIADH with some patients then progressing to persistent central DI, has been occasionally described after TBI [15, 16].”
From Neuroendocrine Disruptions Following Head Injury (2023) · cites this paper as [15]
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- Authors
- Capatina, C., Paluzzi, A., Mitchell, R., & Karavitaki, N.
- Affiliations
- Carol Davila University of Medicine and Pharmacy (RO)
- University Hospitals Birmingham NHS Foundation Trust (GB)
- University of Birmingham (GB)
- Corresponding author
- Karavitaki, Niki
- Venue
- Journal of Clinical Medicine
- Publisher
- MDPI AG
- Published
- 2015-07-13
- Volume
- 4
- Issue
- 7
- Pages
- 1448-1462
- ISSN
- 2077-0383 (ISSN-L)
- PMC
- PMC4519799
- OpenAlex
- W2137669373
- Cited by
- 120
- References
- 82
- Citations by year
- 2026: 7 · 2025: 17 · 2024: 10 · 2023: 8 · 2022: 13 · 2021: 9 · 2020: 14 · 2019: 16 · 2018: 15 · 2017: 5 · 2016: 4 · 2015: 2
- FWCI
- 1.54
- Type
- journal article
- Language
- en
- Open access
- gold
- dx.doi.org
- Licence
- Locations
- Journal of Clinical Medicine (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Nephrology › Electrolyte and hormonal disorders
- Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury and Neurovascular Disturbances
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Keywords
- diabetes insipidus, traumatic brain injury, post-traumatic diabetes insipidus, vasopressin, posterior pituitary dysfunction, hypothalamic dysfunction, syndrome of inappropriate antidiuretic hormone secretion, polyuria, dehydration, hypernatremia, fluid balance, neuroendocrine dysfunction
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