Pituitary dysfunction following traumatic brain injury: clinical perspectives

Figures & data

Figure 1 Suggested inclusion and exclusion criteria for screening of hypopituitarism in patients with mild, moderate, or severe TBI.

Abbreviations: ACTH, adrenocorticotropic hormone; CT, computed tomography; DI, diabetes insipidus; ICU, intensive care unit; MRI, magnetic resonance imaging; TBI, traumatic brain injury.

Figure 2 Prospective screening strategy for anterior pituitary function after head trauma in patients with traumatic brain injury.

Notes: ^aComplicated mild TBI is defined by the presence of at least one of the following conditions: need for hospitalization for more than 24 hours; need for ICU monitoring and/or need for any neurosurgical intervention; presence of acute pituitary hormone changes at the first 2 weeks after TBI (ACTH deficiency and/or central DI); any anatomical changes on initial CT or MRI. ^bPatients should be reminded regarding the symptoms and signs of hypopituitarism, and could be re-evaluated when necessary. ^cDynamic tests for GH deficiency need to be done with an “intent to treat” approach and according to clinical context throughout the follow-up period.
Abbreviations: ACTH, adrenocorticotropic hormone; CT, computed tomography; FSH, follicle-stimulating hormone; GH, growth hormone; ICU, intensive care unit; LH, luteinizing hormone; MRI, magnetic resonance imaging; TBI, traumatic brain injury; TSH, thyroid-stimulating hormone.