gms | German Medical Science

57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

11. bis 14.05.2006, Essen

Neuroendocrine dysfunction following traumatic brain injury: a prospective longitudinal study

Neuroendokrine Funktionsstörungen nach Schädel-Hirn-Trauma: Ergebnisse einer prospektiven longitudinalen Studie

Meeting Abstract

  • corresponding author A. Kleindienst - Neurochirurgische Klinik, Universitätsklinikum Göttingen
  • A. Filis - Neurochirurgische Klinik, Universitätsklinikum Göttingen
  • C. Bock - Neurochirurgische Klinik, Universitätsklinikum Göttingen
  • P. Valbuena - Neurochirurgische Klinik, Universitätsklinikum Göttingen
  • M. Buchfelder - Neurochirurgische Klinik, Universität Erlangen-Nürnberg

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocSO.04.04

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter:

Veröffentlicht: 8. Mai 2006

© 2006 Kleindienst et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen ( Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.



Objective: While neuroendocrine dysfunction at some time point following traumatic brain injury (TBI) has been described in a large number of studies in recent years, there is a lack of longitudinal studies comparing initial laboratory findings of pituitary hormones in the acute period with the results of functional testing of the hypothalamic-pituitary insufficiency more than a year post-injury. The present study was designed to fill this gap.

Methods: In 82 consecutive patients admitted for TBI, the cortico-, thyreo-, gonado- and somatotropic as well as the posterior pituitary function were examined on day 0, 3 and 7 post-injury. To date, in 14 patients dynamic endocrine testing 30-36 months after the trauma is available. Recovery was assessed by the Glasgow Outcome Scale (GOS) at 6 months and by the Nottingham Health Profile at 30-36 months. Consent from the ethical committee was obtained.

Results: Age ranged from 18-92 years (mean 52) and trauma severity was mild to severe (initial Glasgow Coma Score, GCS, 3 to 15). In the acute post-trauma period, most of the patients suffered from hypothalamo-pituitary dysfunction (25% cortico-, 46% thyreo-, 83% gonado- and/or 23% somatotropic system), while at the last follow-up one third of patients demonstrated clinical findings suggestive of hypopituitarism. Dynamic testing of the corticotropic system by an ACTH-test revealed an insufficient increase in all patients (compared to age-matched controls). Growth hormone (GH) deficiency as examined by the GHRH-Arginine test was found in 50%. One patient had an absolute loss of growth hormone secretion (increment <3ng/ml). However, no significant association of GCS or GOS and pituitary dysfunction was established.

Conclusions: The prevalence of hypopituitarism may be as high as 80% early after TBI with some 50% persistent endocrine insufficiency for years, altogether suggesting an alarming socio-economic impact. Since none of our patients had been offered hormonal replacement therapy, we conclude that a substantial percentage of these patients remain undiagnosed and untreated.