Dynamic pituitary hormones change after traumatic brain injury.

OBJECTIVE

To study the dynamic changes of pituitary hormones in traumatic brain injury (TBI) and to correlate the severity and neurological outcome.

PATIENTS AND

METHODS

Dynamic changes in the pituitary hormones were evaluated in 164 patients with TBI on day-1, day-7, day-14, day-21, and day-28 post injury. Admission TBI severity and long-term outcome were assessed with Glasgow Coma Scale (GCS) score and Glasgow Outcome Scale (GOS) score. The pituitary hormonal changes were correlated with TBI severity and outcome.

RESULTS

Of the 164 patients included in the study, pituitary dysfunction was found in 84 patients and in the remaining 80 patients pituitary function was normal. Most of the pituitary hormone deficiencies observed resolved over time; however, a significant proportion of patients had pituitary dysfunction at one month post injury. The hormones associated with poor outcome included growth hormone, thyrotropic hormone, and gonadotropic hormone.

CONCLUSION

Dynamic changes of pituitary hormones in patients with TBI may reflect the severity of injury and also determine the outcome. Deficiency of growth hormone, gonadotropic hormone, and thyrotropic hormone can adversely affect neurological outcome.