Traumatic brain injury and subarachnoid haemorrhage are conditions at high risk for hypopituitarism: Screening study at 3 months after the brain injury

Gianluca Aimaretti, Maria Rosaria Ambrosio, Carolina Di Somma, Alessandra Fusco, Salvatore Cannavò, Maurizio Gasperi, Carla Scaroni, Laura De Marinis, Salvatore Benvenga, Ettore Carlo Degli Uberti, Gaetano Lombardi, Franco Mantero, Enio Martino, Giulio Giordano, Ezio Ghigo

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: Acquired hypopituitarism in adults is obviously suspected in patients with primary hypothalamic-pituitary diseases, particularly after neurosurgery and/or radiotherapy. That brain injuries (BI) can cause hypopituitarism is commonly stated and has been recently emphasized but the management of BI patients does not routinely include neuroendocrine evaluations. AIM: To clarify the occurrence of hypopituitarism in patients after traumatic brain injury (TBI) or subarachnoid haemorrhage (SAH) 3 months after the BI. SUBJECTS AND METHODS: The occurrence of hypopituitarism in conscious patients after traumatic brain injury [TBI, n = 100, 31 women, 69 men; age 37.1 ± 1.8 years; body mass index (BMI) 23.7 ± 0.4 kg/m2; Glasgow Coma Scale (GCS) 3-15] or subarachnoid haemorrhage [SAH, n = 40, 14 men, 26 wpmen, 51-0 ± 2-0 years; 25.0 ± kg/m2; Fisher's scale 1-4] was studied in a multicentre study 3 months after the BI. All patients underwent wide basal hormonal evaluation; the GH/IGF-I axis was evaluated by GHRH + arginine test and IGF-I measurement. RESULTS: In TBI patients, some degree of hypopituitarism was shown in 35%. Total, multiple and isolated deficits were present in 4, 6 and 25%, respectively. Diabetes insipidus was present in 4%. Secondary adrenal, thyroid and gonadal deficit was present in 8, 5 and 17%, respectively. Severe GH deficiency (GHD) was the most frequent pituitary defect (25%). In SAH patients, some degree of hypopituitarism was shown in 37.5%. Despite no total hypopituitarism, multiple and isolated deficits were present in 10 and 27.5%, respectively. Diabetes insipidus was present in 7-5%. Secondary adrenal, thyroid and gonadal deficit was present in 2.5, 7.5 and 12-5%, respectively. Severe GHD was the most frequent defect (25%). CONCLUSIONS: TBI and SAH are conditions associated with high risk of acquired hypopituitarism. The pituitary defect is often multiple and severe GHD is the most frequent defect. Thus neuroendocrine evaluations are always mandatory in patients after brain injuries.

Original languageEnglish
Pages (from-to)320-326
Number of pages7
JournalClinical Endocrinology
Volume61
Issue number3
DOIs
Publication statusPublished - Sep 2004

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Traumatic Brain Hemorrhage
Traumatic Subarachnoid Hemorrhage
Hypopituitarism
Brain Injuries
Subarachnoid Hemorrhage
Diabetes Insipidus
Insulin-Like Growth Factor I
Hypothalamic Diseases
Thyroid Gland
Pituitary Diseases
Glasgow Coma Scale
Traumatic Brain Injury
Neurosurgery
Multicenter Studies
Arginine
Body Mass Index
Radiotherapy

ASJC Scopus subject areas

  • Endocrinology

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Traumatic brain injury and subarachnoid haemorrhage are conditions at high risk for hypopituitarism : Screening study at 3 months after the brain injury. / Aimaretti, Gianluca; Ambrosio, Maria Rosaria; Di Somma, Carolina; Fusco, Alessandra; Cannavò, Salvatore; Gasperi, Maurizio; Scaroni, Carla; De Marinis, Laura; Benvenga, Salvatore; Degli Uberti, Ettore Carlo; Lombardi, Gaetano; Mantero, Franco; Martino, Enio; Giordano, Giulio; Ghigo, Ezio.

In: Clinical Endocrinology, Vol. 61, No. 3, 09.2004, p. 320-326.

Research output: Contribution to journalArticle

Aimaretti, G, Ambrosio, MR, Di Somma, C, Fusco, A, Cannavò, S, Gasperi, M, Scaroni, C, De Marinis, L, Benvenga, S, Degli Uberti, EC, Lombardi, G, Mantero, F, Martino, E, Giordano, G & Ghigo, E 2004, 'Traumatic brain injury and subarachnoid haemorrhage are conditions at high risk for hypopituitarism: Screening study at 3 months after the brain injury', Clinical Endocrinology, vol. 61, no. 3, pp. 320-326. https://doi.org/10.1111/j.1365-2265.2004.02094.x
Aimaretti, Gianluca ; Ambrosio, Maria Rosaria ; Di Somma, Carolina ; Fusco, Alessandra ; Cannavò, Salvatore ; Gasperi, Maurizio ; Scaroni, Carla ; De Marinis, Laura ; Benvenga, Salvatore ; Degli Uberti, Ettore Carlo ; Lombardi, Gaetano ; Mantero, Franco ; Martino, Enio ; Giordano, Giulio ; Ghigo, Ezio. / Traumatic brain injury and subarachnoid haemorrhage are conditions at high risk for hypopituitarism : Screening study at 3 months after the brain injury. In: Clinical Endocrinology. 2004 ; Vol. 61, No. 3. pp. 320-326.
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abstract = "OBJECTIVE: Acquired hypopituitarism in adults is obviously suspected in patients with primary hypothalamic-pituitary diseases, particularly after neurosurgery and/or radiotherapy. That brain injuries (BI) can cause hypopituitarism is commonly stated and has been recently emphasized but the management of BI patients does not routinely include neuroendocrine evaluations. AIM: To clarify the occurrence of hypopituitarism in patients after traumatic brain injury (TBI) or subarachnoid haemorrhage (SAH) 3 months after the BI. SUBJECTS AND METHODS: The occurrence of hypopituitarism in conscious patients after traumatic brain injury [TBI, n = 100, 31 women, 69 men; age 37.1 ± 1.8 years; body mass index (BMI) 23.7 ± 0.4 kg/m2; Glasgow Coma Scale (GCS) 3-15] or subarachnoid haemorrhage [SAH, n = 40, 14 men, 26 wpmen, 51-0 ± 2-0 years; 25.0 ± kg/m2; Fisher's scale 1-4] was studied in a multicentre study 3 months after the BI. All patients underwent wide basal hormonal evaluation; the GH/IGF-I axis was evaluated by GHRH + arginine test and IGF-I measurement. RESULTS: In TBI patients, some degree of hypopituitarism was shown in 35{\%}. Total, multiple and isolated deficits were present in 4, 6 and 25{\%}, respectively. Diabetes insipidus was present in 4{\%}. Secondary adrenal, thyroid and gonadal deficit was present in 8, 5 and 17{\%}, respectively. Severe GH deficiency (GHD) was the most frequent pituitary defect (25{\%}). In SAH patients, some degree of hypopituitarism was shown in 37.5{\%}. Despite no total hypopituitarism, multiple and isolated deficits were present in 10 and 27.5{\%}, respectively. Diabetes insipidus was present in 7-5{\%}. Secondary adrenal, thyroid and gonadal deficit was present in 2.5, 7.5 and 12-5{\%}, respectively. Severe GHD was the most frequent defect (25{\%}). CONCLUSIONS: TBI and SAH are conditions associated with high risk of acquired hypopituitarism. The pituitary defect is often multiple and severe GHD is the most frequent defect. Thus neuroendocrine evaluations are always mandatory in patients after brain injuries.",
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T1 - Traumatic brain injury and subarachnoid haemorrhage are conditions at high risk for hypopituitarism

T2 - Screening study at 3 months after the brain injury

AU - Aimaretti, Gianluca

AU - Ambrosio, Maria Rosaria

AU - Di Somma, Carolina

AU - Fusco, Alessandra

AU - Cannavò, Salvatore

AU - Gasperi, Maurizio

AU - Scaroni, Carla

AU - De Marinis, Laura

AU - Benvenga, Salvatore

AU - Degli Uberti, Ettore Carlo

AU - Lombardi, Gaetano

AU - Mantero, Franco

AU - Martino, Enio

AU - Giordano, Giulio

AU - Ghigo, Ezio

PY - 2004/9

Y1 - 2004/9

N2 - OBJECTIVE: Acquired hypopituitarism in adults is obviously suspected in patients with primary hypothalamic-pituitary diseases, particularly after neurosurgery and/or radiotherapy. That brain injuries (BI) can cause hypopituitarism is commonly stated and has been recently emphasized but the management of BI patients does not routinely include neuroendocrine evaluations. AIM: To clarify the occurrence of hypopituitarism in patients after traumatic brain injury (TBI) or subarachnoid haemorrhage (SAH) 3 months after the BI. SUBJECTS AND METHODS: The occurrence of hypopituitarism in conscious patients after traumatic brain injury [TBI, n = 100, 31 women, 69 men; age 37.1 ± 1.8 years; body mass index (BMI) 23.7 ± 0.4 kg/m2; Glasgow Coma Scale (GCS) 3-15] or subarachnoid haemorrhage [SAH, n = 40, 14 men, 26 wpmen, 51-0 ± 2-0 years; 25.0 ± kg/m2; Fisher's scale 1-4] was studied in a multicentre study 3 months after the BI. All patients underwent wide basal hormonal evaluation; the GH/IGF-I axis was evaluated by GHRH + arginine test and IGF-I measurement. RESULTS: In TBI patients, some degree of hypopituitarism was shown in 35%. Total, multiple and isolated deficits were present in 4, 6 and 25%, respectively. Diabetes insipidus was present in 4%. Secondary adrenal, thyroid and gonadal deficit was present in 8, 5 and 17%, respectively. Severe GH deficiency (GHD) was the most frequent pituitary defect (25%). In SAH patients, some degree of hypopituitarism was shown in 37.5%. Despite no total hypopituitarism, multiple and isolated deficits were present in 10 and 27.5%, respectively. Diabetes insipidus was present in 7-5%. Secondary adrenal, thyroid and gonadal deficit was present in 2.5, 7.5 and 12-5%, respectively. Severe GHD was the most frequent defect (25%). CONCLUSIONS: TBI and SAH are conditions associated with high risk of acquired hypopituitarism. The pituitary defect is often multiple and severe GHD is the most frequent defect. Thus neuroendocrine evaluations are always mandatory in patients after brain injuries.

AB - OBJECTIVE: Acquired hypopituitarism in adults is obviously suspected in patients with primary hypothalamic-pituitary diseases, particularly after neurosurgery and/or radiotherapy. That brain injuries (BI) can cause hypopituitarism is commonly stated and has been recently emphasized but the management of BI patients does not routinely include neuroendocrine evaluations. AIM: To clarify the occurrence of hypopituitarism in patients after traumatic brain injury (TBI) or subarachnoid haemorrhage (SAH) 3 months after the BI. SUBJECTS AND METHODS: The occurrence of hypopituitarism in conscious patients after traumatic brain injury [TBI, n = 100, 31 women, 69 men; age 37.1 ± 1.8 years; body mass index (BMI) 23.7 ± 0.4 kg/m2; Glasgow Coma Scale (GCS) 3-15] or subarachnoid haemorrhage [SAH, n = 40, 14 men, 26 wpmen, 51-0 ± 2-0 years; 25.0 ± kg/m2; Fisher's scale 1-4] was studied in a multicentre study 3 months after the BI. All patients underwent wide basal hormonal evaluation; the GH/IGF-I axis was evaluated by GHRH + arginine test and IGF-I measurement. RESULTS: In TBI patients, some degree of hypopituitarism was shown in 35%. Total, multiple and isolated deficits were present in 4, 6 and 25%, respectively. Diabetes insipidus was present in 4%. Secondary adrenal, thyroid and gonadal deficit was present in 8, 5 and 17%, respectively. Severe GH deficiency (GHD) was the most frequent pituitary defect (25%). In SAH patients, some degree of hypopituitarism was shown in 37.5%. Despite no total hypopituitarism, multiple and isolated deficits were present in 10 and 27.5%, respectively. Diabetes insipidus was present in 7-5%. Secondary adrenal, thyroid and gonadal deficit was present in 2.5, 7.5 and 12-5%, respectively. Severe GHD was the most frequent defect (25%). CONCLUSIONS: TBI and SAH are conditions associated with high risk of acquired hypopituitarism. The pituitary defect is often multiple and severe GHD is the most frequent defect. Thus neuroendocrine evaluations are always mandatory in patients after brain injuries.

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