Clinical research studyThe natural history of post-traumatic hypopituitarism: Implications for assessment and treatment
Section snippets
Sample
Fifty white patients with head trauma, aged 15 to 65 years, who were admitted to the Beaumont Hospital neurosurgical unit between October 2002 and April 2003, were included in the study. The clinical characteristics of the patients were reported previously6 and are summarized in Table 1. All patients had severe or moderate injury, defined by the initial post-resuscitation and pre-sedation Glasgow Coma Scale scores,7, 8 and all had computed tomography evidence of brain injury.9 The cause of the
Method
The study was approved by the ethics section of the Beaumont Hospital Medical Research Committee. All patients (or next-of-kin) gave informed consent.
Patients were assessed on 3 occasions: acute phase (median 12 days, range 7-20 days), at 6 months (during intensive rehabilitation), and at 12 months (end of intensive rehabilitation) after injury. Functional recovery at 1 year was assessed using the Glasgow Outcome Scale.10
Results
All 50 patients completed the acute phase studies. Two patients died after hospital discharge; thus, follow-up data are available for 48 patients.
Discussion
Our data show that anterior pituitary hormone abnormalities, which occur soon after traumatic brain injury, are transient in some patients, and that recovery occurred by 6 months in the majority of patients. Hyperprolactinemia and gonadotropin deficiency are particularly likely to recover completely in the majority of patients. Although recovery of normal growth hormone production in two thirds of patients and cortisol production in one half of patients were demonstrated in the post-acute
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This work was supported by an unrestricted education grant obtained in open competition from Pfizer International Research Grants.