ESICON 2017 Abstracts

Objectives: Incidence of anterior pituitary hormonal dysfunction at 0-10 days of TBI and at 6 th month of TBI.

Materials and Methods: It's Prospective observational study with sample size 10 patients having moderate to severe traumatic head injury (GCS <12) and subarachnoid haemorrhage, admitted in neurosurgical ICU. Hormonal evaluation for serum Cortisol, Growth Hormone, IGF-1, LH, FSH, Testosterone, Estradiol (E2), TSH, free T4 and prolactin was done on 0-10 days of traumatic brain injury (TBI) at 8am and labelled as baseline tests. Subsequent hormonal work up was done around 6 th month of TBI with same panel of tests at 8 am and data was compared with the baseline. Data was presented as mean and standard deviation (SD) and comparison between the groups was done by ANOVA test.

Results: At baseline 40% patients had one hormonal axes dysfunction and 30% patients had 2 axes involvement and 30% had >2 axes dysfunction. At 6 th month 30% patients had >2 axes involvement and 20% had single axis involvement. Hypocortisolism at baseline was 40% and 20% at 6 th month. Serum growth hormone was normal in all patients at baseline and 6 th month. Serum IGF-1 was low in 40% patients at baseline and 20% at 6 th month. Serum prolactin was high in 30% cases at baseline and 10% at 6 th month. Serum LH was low in 30% cases at baseline and at 6 th month. Serum FSH was low in 40% cases at baseline and at 30% at 6 th month. Serum testosterone was low in 20% cases at baseline and at 6 th month. Serum TSH was low in 30% cases at baseline and 10% at 6 th month.

Conclusion: Recovery of HPA axis and GH-IGF-1 axis were observed in 50% patients at 6 th month of TBI, so it's recommended that regular check of HPA axis at 6 th of TBI. Sick euthyroid syndrome incidence was 30% at acute phase only. Clinically non significant hyperprolactinemia incidence was 30% in acute phase which was recovered in 70% cases over 6 months. So regular screening of anterior pituitary hormones is required to detect new onset dysfunction and to avoid unnecessary treatment.