The history of pituitary dysfunction after traumatic brain injury

Benvenga, Salvatore

doi:10.1007/s11102-019-00949-9

Cited by 12 publications

(6 citation statements)

References 80 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Benvenga et al (5) demostraron, en una revisión realizada entre mayo del 2000 y octubre del 2018, que el hipopituitarismo postraumático (HPPT) representa el 7,2 % de todas las causas de hipopituitarismo (41). En los pacientes con TCE, el HPPT tiene una prevalencia del 27,5 %, con un rango entre 15 y 68 %, el cual es variable según el eje hormonal afectado y el intervalo de evaluación endocrina posTCE (los datos de esta revisión se resumen en la tabla 1), vale aclarar que la búsqueda incluyó el descriptor ("cognitive dysfunction") que puede excluir aquellos artículos que no discutan este aspecto.…”

Section: Resultados ¿Cuántos Pacientes Con Trauma Craneoencefálico Pr...unclassified

“…La disrupción de la barrera hematoencefálica posterior al trauma o la necrosis glandular lleva a la liberación de proteínas cerebrales (antígenos hipotalámicos e hipofisiarios) en la circulación, desencadenando una respuesta inmune que forma: autoanticuerpos AAP (anticuerpos antipituitarios), AAH (anticuerpos antihipotalámicos) y enolasa neuronal específica (NSE), los cuales causan insuficiencia hipofisiaria y se han correlacionado en estudios prospectivos en seguimiento por varios años con títulos altos de AAP/AAH y aparición de daño hormonal, previamente no documentados. Esta información favorecen la hipótesis de que la neuroinflamación aguda y los procesos autoinmunes tienen una relación con la dinámica hormonal de estos pacientes y su impacto a corto y largo plazo (figura 2) (1,29,33,41,44,55). Volumen Las alteraciones neurohipofisiarias son comunes en los primeros días posteriores al TCE; la hiponatremia secundaria al síndrome de secreción inadecuada de hormona antidiurética (Siadh), ahora denominada déficit de argininavasopresina (D-AVP), se reporta entre el 15 % y el 20 % de los casos y se asocia a convulsiones, hospitalizaciones prolongadas y pobres resultados en la rehabilitación.…”

Section: Resultados ¿Cuántos Pacientes Con Trauma Craneoencefálico Pr...unclassified

See 1 more Smart Citation

Alteraciones hipofisiarias postraumáticas y trastornos cognitivos

Tovar

Rubiano

Jiménez-Cañizales

2023

Rev.ACE

View full text Add to dashboard Cite

Contexto: el trauma craneoencefálico (TCE) es un problema de salud pública con secuelas neurológicas y cognitivas severas que pueden asociarse a disfunción endocrina hipofisiaria. El compromiso hipofisiario aumenta su morbimortalidad y según el eje hormonal afectado se presentan repercusiones cognitivas y neuroconductuales variables que afectan el proceso de rehabilitación y el reintegro a la vida social de los sobrevivientes. Objetivo: realizar una revisión exploratoria de la literatura sobre la relación que existe entre las alteraciones hormonales hipofisiarias y las alteraciones neurocognitivas posteriores al trauma craneoencefálico. Métodos: se realizó una búsqueda de la literatura para dar respuesta a la pregunta: ¿cuáles alteraciones neurocognitivas se asocian a disfunción hipofisiaria después de un trauma craneoencefálico? Se usaron los descriptores: hipófisis, hipopituitarismo, trauma craneoencefálico, disfunción cognitiva en las bases de datos PubMed® y Scopus; además, se planteó la misma pregunta por cada uno de los ejes hipofisiarios. Resultados: se encontraron un total de 48 artículos en las bases de datos descritas principalmente documentos de tipo descriptivo. Conclusión: la incidencia de alteraciones hormonales hipofisiarias después de un trauma craneoencefálico son frecuentes y existe una posible relación con cambios cognitivos posteriores, por ello deben sospecharse y estudiarse. Siempre se debe interrogar sobre el diagnóstico de una disfunción hipofisiaria a los pacientes con TCE y alteraciones neurocognitivas.

show abstract

Section: Resultados ¿Cuántos Pacientes Con Trauma Craneoencefálico Pr...unclassified

Alteraciones hipofisiarias postraumáticas y trastornos cognitivos

Tovar

Rubiano

Jiménez-Cañizales

2023

Rev.ACE

View full text Add to dashboard Cite

show abstract

“…The incidence of post-traumatic hypopituitarism (PTHP) is likely underestimated. Based on the review of literature published between May 2000 and October 2018, Benvenga defined that PTHP accounts for 7.2% of the total cases of hypopituitarism (9). The prevalence of PTHP among patients with a history of TBI is estimated to be 15-68% (10,11,12).…”

Section: Introduction and Epidemiologymentioning

confidence: 99%

Traumatic brain injuries induced pituitary dysfunction: a call for algorithms

Gilis‐Januszewska

Kluczyński

Hubalewska‐Dydejczyk

2020

Endocrine Connections

View full text Add to dashboard Cite

Traumatic brain injury affects many people each year, resulting in a serious burden of devastating health consequences. Motor-vehicle and work-related accidents, falls, assaults, as well as sport activities are the most common causes of traumatic brain injuries. Consequently, they may lead to permanent or transient pituitary insufficiency that causes adverse changes in body composition, worrisome metabolic function, reduced bone density, and a significant decrease in one’s quality of life. The prevalence of post-traumatic hypopituitarism is difficult to determine, and the exact mechanisms lying behind it remain unclear. Several probable hypotheses have been suggested. The diagnosis of pituitary dysfunction is very challenging both due to the common occurrence of brain injuries, the subtle character of clinical manifestations, the variable course of the disease, as well as the lack of proper diagnostic algorithms. Insufficiency of somatotropic axis is the most common abnormality, followed by presence of hypogonadism, hypothyroidism, hypocortisolism, and diabetes insipidus. The purpose of this review is to summarize the current state of knowledge about post-traumatic hypopituitarism. Moreover, based on available data and on our own clinical experience, we suggest an algorithm for the evaluation of post-traumatic hypopituitarism. In addition, well-designed studies are needed to further investigate the pathophysiology, epidemiology, and timing of pituitary dysfunction after a traumatic brain injury with the purpose of establishing appropriate standards of care.

show abstract

“…Military populations, similar to law enforcement, are at increased risk of both blast‐related trauma exposure and TBI‐associated hypopituitarism (Benvenga, ). Wilkinson et al () first reported the potential link between hypopituitarism and blast exposure (Wilkinson et al, ).…”

Section: Introductionmentioning

confidence: 99%

Neuroendocrine function and associated mental health outcomes following mild traumatic brain injury in OEF‐deployed service members

Ciarlone

Statz

Goodrich

et al. 2020

J of Neuroscience Research

View full text Add to dashboard Cite

Mild traumatic brain injury (mTBI) has been linked to mental health disorders (MHDs) and pituitary function alterations. Due to the complex relationship of mTBI, the neuroendocrine system, and MHDs, we propose that neuroendocrine dysfunction (NED) may play a role in negative long-term health outcomes. The goal of this study was to determine if blast-concussed service members (SMs) have a stronger likelihood of developing NED. We hypothesized that NED either pre-or post-injury is associated with poor mental and physical health outcomes. Serum samples from the Armed Forces Health Surveillance Branch were obtained from concussed (n = 59) and nonconcussed (n = 72) SMs treated at the Concussion Restoration Care Center (CRCC) in Afghanistan. Serum was collected within 2 years prior to deployment and one or two times within 3 years following their CRCC visit. Samples were analyzed for luteinizing hormone (LH), testosterone, human growth hormone, cortisol, and prolactin to assess post-injury neuroendocrine function. Results indicate that SMs who incurred an mTBI exhibited long-term LH and testosterone deficiencies 3 years following injury compared to controls. Specifically, 47.6% of head-injured SMs displayed hypofunction in at least one of five hormones at 3 years post-injury. Anxiety disorders were the most common MHD observed in concussed SMs with hypopituitarism, while there was also a trend for SMs with chronic pituitary dysfunction to have MHD diagnoses. Findings indicate blast-related mTBI may be associated with long-term health outcomes following a period of incubation. Neuroendocrine screenings may increase treatment opportunities, inform rehabilitation strategies, and improve overall quality of life for patients. K E Y W O R D S concussion, military, neuroendocrine, pituitary, traumatic brain injury Published 2020. This article is a U.S. Government work and is in the public domain in the USA.| 1175 CIARLONE Et AL.

show abstract

The history of pituitary dysfunction after traumatic brain injury

Cited by 12 publications

References 80 publications

Alteraciones hipofisiarias postraumáticas y trastornos cognitivos

Alteraciones hipofisiarias postraumáticas y trastornos cognitivos

Traumatic brain injuries induced pituitary dysfunction: a call for algorithms

Neuroendocrine function and associated mental health outcomes following mild traumatic brain injury in OEF‐deployed service members

Contact Info

Product

Resources

About