The Development of Neuroendocrine Disturbances over Time: Longitudinal Findings in Patients after Traumatic Brain Injury and Subarachnoid Hemorrhage

International Journal of Molecular Sciences

Anna Kopczak¹  Carmen Krewer³  Manfred Schneider³  Ilonka Kreitschmann-Andermahr²  Harald Jörn Schneider⁴  Günter Karl Stalla¹ 

[1] Clinical Neuroendocrinology Group, Max Planck Institute of Psychiatry, Kraepelinstraße 2-10, Munich 80804, Germany;Department of Neurosurgery, University of Duisburg-Essen, Hufelandstraße 55, Essen 45147, Germany;Schön Klinik Bad Aibling, Kolbermoorer Straße 72, Bad Aibling 83043, Germany;Department of Endocrinology, Ludwig-Maximilians-University, Ziemssenstraße 1, Munich 80336, Germany;

关键词: hypopituitarism;    traumatic brain injury;    subarachnoid hemorrhage;    neuroendocrinology;    posttraumatic hypopituitarism;   

DOI  :  10.3390/ijms17010002

来源: mdpi

【 摘 要 】

Previous reports suggest that neuroendocrine disturbances in patients with traumatic brain injury (TBI) or aneurysmal subarachnoid hemorrhage (SAH) may still develop or resolve months or even years after the trauma. We investigated a cohort of n = 168 patients (81 patients after TBI and 87 patients after SAH) in whom hormone levels had been determined at various time points to assess the course and pattern of hormonal insufficiencies. Data were analyzed using three different criteria: (1) patients with lowered basal laboratory values; (2) patients with lowered basal laboratory values or the need for hormone replacement therapy; (3) diagnosis of the treating physician. The first hormonal assessment after a median time of three months after the injury showed lowered hormone laboratory test results in 35% of cases. Lowered testosterone (23.1% of male patients), lowered estradiol (14.3% of female patients) and lowered insulin-like growth factor I (IGF-I) values (12.1%) were most common. Using Criterion 2, a higher prevalence rate of 55.6% of cases was determined, which correlated well with the prevalence rate of 54% of cases using the physicians’ diagnosis as the criterion. Intraindividual changes (new onset insufficiency or recovery) were predominantly observed for the somatotropic axis (12.5%), the gonadotropic axis in women (11.1%) and the corticotropic axis (10.6%). Patients after TBI showed more often lowered IGF-I values at first testing, but normal values at follow-up (p < 0.0004). In general, most patients remained stable. Stable hormone results at follow-up were obtained in 78% (free thyroxine (fT4) values) to 94.6% (prolactin values).

【 授权许可】

CC BY   
© 2015 by the authors; licensee MDPI, Basel, Switzerland.