@article{ref1,
title="Evaluation of pituitary function after traumatic brain injury in childhood",
journal="Clinical endocrinology",
year="2010",
author="Khadr, Sophie N. and Crofton, Patricia M. and Jones, Patricia A. and Wardhaugh, Barbara and Roach, Jennifer and Drake, Amanda J. and Minns, Robert A. and Kelnar, Christopher J. H.",
volume="73",
number="5",
pages="637-643",
abstract="Objectives: Post-traumatic hypopituitarism is well described among adult traumatic brain injury survivors. We aimed to determine the prevalence and clinical significance of pituitary dysfunction after head injury in childhood. Design: Retrospective exploratory study. Patients: 33 survivors of accidental head injury (27 males). Mean (range) age at study was 13.4y (5.4-21.7y) and median (range) interval since injury, 4.3y (1.4-7.8y). Functional outcome at study: 15 good recovery, 16 moderate disability, two severe disability. Measurements: Early morning urine osmolality and basal hormone evaluation were followed by the GnRH and insulin tolerance (n=25) or glucagon tests (if previous seizures, n=8). Subjects were not primed. Head injury details were extracted from patient records. Results: No subject had short stature (mean height SD score +0.50, range -1.57 to +3.00). Sub-optimal GH responses (<5 mug/L) occurred in six peri-pubertal males (one with slow growth on follow-up) and one post-pubertal male (peak GH 3.2 mug/L). Median peak cortisol responses to insulin tolerance or glucagon tests were 538 and 562 nmol/L. 9/25 and 2/8 subjects had sub-optimal responses respectively, two with high basal cortisol levels. None required routine glucocorticoid replacement. In three, steroid cover was recommended for moderate/severe illness or injury. One male was prolactin deficient. Other basal endocrine results and GnRH-stimulated LH and FSH were appropriate for age, sex and pubertal stage. Abnormal endocrine findings were unrelated to the severity or other characteristics of TBI, or functional outcome. Conclusions: No clinically significant endocrinopathy was identified amongst survivors of accidental childhood TBI, although minor pituitary hormone abnormalities were observed.<p /> <p>Language: en</p>",
language="en",
issn="0300-0664",
doi="10.1111/j.1365-2265.2010.03857.x",
url="http://dx.doi.org/10.1111/j.1365-2265.2010.03857.x"
}