ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2008) 16 P380

Pituitary insufficiency after traumatic brain injury and the coherence with psychological disorders

Dorothee Wachter1, Katja Guendling1, Matthias F Oertel1, Hilmar Stracke2 & Dieter-Karsten Boeker1

1Department of Neurosurgery, University of Giessen and Marburg GmbH, Campus Giessen, Giessen, Hessen, Germany; 2Department of Endocrinology, University of Giessen and Marburg GmbH, Campus Giessen, Giessen, Hessen, Germany.

Objective: In order to explain physical, cognitive and psychological disorders after traumatic brain injury (TBI), several studies have implicated a major role of posttraumatic pituitary insufficiency (prevalence 25–70%). Aim of this study was to determine the correlation between cerebral tissue damage, corresponding initial findings on radiographic imaging and pituitary insufficiency versus psychological disorders (like fatigue, nervousness, depression or excitability).

Material and methods: About 171 patients with TBI had been contacted, 55 (32%) agreed to participate in the study. Hormonal stimulation tests had been performed, either if the basal hormone screening revealed an abnormality or if the patient answered ‘yes’ in at least one question of the pituitary questionnaire.

The following data had been included into a multivariate analysis: initial GCS, GOS, pituitary questionnaire, age, prevalence of pituitary insufficiency and initial findings on radiographic imaging.

Results: Overall, 14 out of 55 patients (25.4%) presented with pituitary insufficiency; one of them with two hormonal deficits. Neuropsychological changes e.g. nervousness, excitability and depressive episodes were present in 67% of the patients.

Conclusion: About 67% of the patients developed neuropsychological disorders after TBI, whereas only 25% of the patients revealed any type of pituitary dysfunction. This might lead to the assumption, that general brain tissue damage has more influence, regarding the development of psychological disorders after TBI, than pituitary dysfunction.

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