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59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

01. - 04.06.2008, Würzburg

Hypopituitarism following traumatic brain injury – short- and long-term results

Hypophysäre Insuffizienz nach Schädel-Hirn-Verletzungen – Kurz- und Langzeitergebnisse

Meeting Abstract

  • corresponding author R. Stendel - Klinik für Neurochirurgie, Charité - Universitätsmedizin Berlin
  • I. Fiss - Klinik für Neurochirurgie, Charité - Universitätsmedizin Berlin
  • E. Peltonen - Klinik für Neurochirurgie, Charité - Universitätsmedizin Berlin
  • A. Arafat - Klinik für Endokrinologie und Ernährungsmedizin, Charité - Universitätsmedizin Berlin
  • A. Pfeiffer - Klinik für Endokrinologie und Ernährungsmedizin, Charité - Universitätsmedizin Berlin

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocMO.14.05

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2008/08dgnc135.shtml

Veröffentlicht: 30. Mai 2008

© 2008 Stendel et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Recent data have suggested that significant pituitary dysfunction following traumatic brain injury is common. The pathomechanism leading to these dysfunction is not known. The aim of this study was to investigate the incidence and kind of pituitary dysfunction following traumatic brain injury after a longer time interval.

Methods: A total of 52 patients (30 male, 22 female, mean age 50.8, age range 16–88 years) were included. The patients were investigated 1 and 5 years following TBI. Basal hormone values and dynamic testing of pituitary function was performed using combined anterior pituitary test and glucose tolerance test. The results were correlated to data on the mechanism and magnitude of the accident and the subsequent trauma sequels.

Results: In 58% of the patients, the dysfunction of at least one hormone axis could be demonstrated. In 12% a combination of deficiencies for 2 or 3 axes could be found. The incidence of deficiencies of the gonadotropines and of prolactine was significantly lower when compared to the growth hormone, TSH and ACTH/Cortisol axes. There were no significant differences between the incidences 1 and 5 years following TBI. In multivariate analysis, CSF fistula, skull base fracture, GCS score, increased ICP and contusions could not be identified as risk factors for posttraumatic pituitary dysfunction.

Conclusions: In conclusion we found that more than 50% of the patients develop persistent pituitary dysfunction 1 and 5 years following TBI. The growth hormone and ACTH/Cortisol axes were significantly more affected. The functional testing using overlapping tests seems to increase sensitivity for the detection of pituitary dysfunction. It should be performed in all patients 1 year following TBI.