TY  - JOUR
PY  - 2019//
TI  - Impact of pituitary dysfunction on cognitive and global outcome after traumatic brain injury and aneurysmal subarachnoid haemorrhage
JO  - Journal of rehabilitation medicine
A1  - Tölli, Anna
A1  - Höybye, Charlotte
A1  - Bellander, Bo-Michael
A1  - Borg, Jörgen
SP  - 264
EP  - 272
VL  - 51
IS  - 4
N2  - OBJECTIVE: To explore associations between pituitary dysfunction and clinical outcome at 12 months after traumatic brain injury and aneurysmal subarachnoid haemorrhage. <br><br>METHODS: Prospective cohort study of 82 patients with traumatic brain injury and 45 with aneurysmal subarachnoid haemorrhage, included at 1 neurointensive care unit. Baseline data comprised age, sex, Glasgow Coma Scale (GCS) score, S100B and pupil light reactions. Hormone data were collected in the neurointensive care unit and 3, 6 and 12 months. Outcome was assessed with Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS), Rancho Los Amigos Cognitive Scale-Revised (RLAS-R) and Glasgow Outcome Scale Extended (GOSE). <br><br>RESULTS: The most frequent hormonal deviations were hypogonadotropic hypogonadism (38%) and hypercortisolism (52%). At 12 months, performance on BNIS was impaired in 54% and GOSE in 37%. Controlling for baseline variables, low levels of gonadal hormones were associated with lower GOSE score (b = -0.80, p = 0.033), high levels of prolactin with lower RLAS (b = -1.42, p = 0.034) and high levels of S-insulin-like growth factor I (IGF-I) with lower RLAS level (b = -1.78, p = 0.002) and lower GOSE score (b = -1.49, p = 0.006). <br><br>CONCLUSION: These data suggest that pituitary dysfunctions during the first year after traumatic brain injury and aneurysmal subarachnoid haemorrhage may have clinically relevant, independent effects on clinical outcome at 12 months.<p />  <p>Language: en</p>
LA  - en
SN  - 1650-1977
UR  - http://dx.doi.org/10.2340/16501977-2531
ID  - ref1
ER  -