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Abnormalities of pituitary function after traumatic brain injury in children

Tamás Niederland1, Helga Makovi, Veronika Gál

  • 1Department of Pediatrics, Petz Aladár County Teaching Hospital, Vasvári P. u 2, H-9023 Gyor, Hungary. niederlandt@petz.gyor.hu

Journal of Neurotrauma
|February 1, 2007
PubMed

Insights

Traumatic brain injury (TBI) in children frequently causes pituitary dysfunction, particularly affecting growth hormone (GH) and cortisol levels. Early screening for hypopituitarism is recommended after any childhood head injury requiring hospitalization.

Area of Science:

  • Pediatric Endocrinology
  • Neurotrauma
  • Hormone Research

Background:

  • Traumatic brain injury (TBI) is a known cause of neuroendocrine dysfunction in adults.
  • Endocrine consequences of childhood head injuries are less understood, with limited case reports.
  • Pituitary function assessment is crucial for children with a history of head trauma.

Purpose of the Study:

  • To investigate anterior pituitary function in children following hospitalization for mild to severe head trauma.
  • To identify the prevalence and specific hormone deficiencies post-TBI in pediatric patients.
  • To correlate pituitary dysfunction with TBI severity and patient demographics.

Main Methods:

  • An endocrine follow-up study involving 26 children with TBI history and 21 age-matched controls.
  • Measurement of basal and stimulated anterior pituitary and peripheral hormone levels using routine laboratory methods.
  • Hormone level assessment included growth hormone (GH) and cortisol via L-DOPA and insulin stimulation tests.

Main Results:

  • Pituitary dysfunction was detected in 61% of children with TBI history.
  • Significantly lower growth hormone (GH) parameters were observed in the TBI group post-stimulation.
  • Cortisol levels were significantly lower in TBI patients throughout the insulin tolerance test compared to controls.
  • The severity of TBI did not correlate with the degree of pituitary dysfunction.

Conclusions:

  • Children with TBI have a high risk of developing hypopituitarism, even without apparent clinical symptoms.
  • Growth hormone and cortisol deficiencies are common endocrine consequences of childhood TBI.
  • Routine pituitary function screening is recommended for all children hospitalized for brain trauma.

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