Hypopituitarism 3 and 12 months after traumatic brain injury and subarachnoid haemorrhage

ABSTRACT

Objective. High prevalence of hypopituitarism (HP) has been reported after traumatic brain injury (TBI) and subarachnoid haemorrhage (SAH). The aim of the study was to prospectively evaluate the prevalence and progression of HP in patients after TBI and SAH in Icelandic population.

Design: A 12 month prospective single-centre study.

Methods and procedures: A total of 27 patients were included, 15 patients with TBI and 12 patients with SAH. Pituitary function was evaluated with baseline hormone measurements and diagnostic tests. An insulin tolerance test was used unless contraindicated, then the GHRH-arginine test and Synachten test were used.

Results. At three months, 16.7% (2/12) of the patients had HP after TBI and 33.3% (4/12) after SAH. At 12 months, 21.4% (3/14) of patients had HP after TBI and 9.1% (1/11) after SAH. Gonadotropin deficiency was the most common deficiency at 3 months and GH and gonadotropin deficiency at 12 months.

Conclusions. There is a considerable risk of HP after TBI and reason to study pituitary function further in patients with SAH. We believe that neuroendocrine evaluation is important in these patients. Since recovery commonly occurs 12 months after the event, evaluation should be performed after that time if not clinically indicated earlier.

KEYWORDS:

• Hypopituitarism
• Traumatic brain injury (TBI)
• Subarachnoid haemorrhage (SAH)
• insulin tolerance test
• GHRH-arginine test

Declaration of interest

The authors declare that they have no conflict of interest.