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Pituitary Function in the Acute Phase of Traumatic Brain Injury and Subarachnoid Hemorrhage

International Journal of Clinical Medicine 2015年第6期6卷 411-422页

作者： Anna Tolli Jorgen Borg Bo-Michael Bellander Charlotte Hoybye Department of Clinical Sciences Karolinska InstitutetDanderyd HospitalStockholmSweden Department of Clinical Neuroscience Section for NeurosurgeryKarolinska InstitutetStockholmSweden Department of Molecular Medicine and Surgery Karolinska Institutet and Department of EndocrinologyMetabolism and DiabetologyKarolinska University HospitalStockholmSweden

Background: Pituitary insufficiencies after traumatic brain injury (TBI) and subarachnoid haem-orrhage (SAH) have been reported with very varying frequencies. The aim of this study was to describe the pituitary function in the acute phase after TBI and SAH in a cohort of adults and relate the results to injury variables. Methods: Adults admitted to the neurointensive care unit in our hospital after moderate and severe TBI or SAH were included prospectively. Demographic, clinical, laboratory, including ACTH stimulation test, and radiological data were collected. Results: A total of 130 adults, 84 (19 women/65 men) with TBI and 46 (38 women/8 men) with SAH were included. Nine patients with TBI and six patients with SAH responded insufficiently to ACTH stimulation;14 patients with TBI and 9 patients with SAH had low fT4 and low-normal TSH levels. No relations were seen between hormonal levels and injury variables. Conclusions: Pituitary deficiencies occur after TBI and SAH, and a continuous endocrine evaluation of these patients is important. Our study could not define a marker for increased risk for pituitary deficiency. The long-term clinical outcome of the pathological hormone levels in the early phase after TBI and SAH is not known in detail and further studies to elucidate this are needed.

关键词： Hormone Disturbance Pituitary Traumatic Brain Injury subarachnoidal haemorrhage

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