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Endocrine changes after pediatric traumatic brain injury

Susan R Rose1, Bethany A Auble

  • 1Cincinnati Children's Hospital Medical Center, University of Cincinnati, 3333 Burnet Avenue, MLC 7012, Cincinnati, OH 45229, USA. susan.rose@cchmc.org

Pituitary
|November 8, 2011
PubMed

Insights

Childhood traumatic brain injury (TBI) can cause lasting endocrine issues. Survivors require regular screening for hypopituitarism, affecting growth and puberty.

Area of Science:

  • Pediatric Endocrinology
  • Neuroendocrinology
  • Pediatric Traumatology

Background:

  • Traumatic brain injury (TBI) is a significant cause of long-term disability in children.
  • While endocrine consequences in adults are studied, pediatric TBI endocrine effects remain less understood.
  • The hypothalamic-pituitary axis is vulnerable to injury, impacting hormonal regulation.

Purpose of the Study:

  • To review the current literature on endocrine deficiencies following pediatric TBI.
  • To highlight the prevalence and types of hormonal disturbances in children post-TBI.
  • To emphasize the need for routine endocrine surveillance in pediatric TBI survivors.

Main Methods:

  • Literature review of studies on pediatric traumatic brain injury and endocrine outcomes.
  • Analysis of reported acute and long-term endocrine changes.
  • Synthesis of data on specific pituitary hormone deficiencies.

Main Results:

  • Acute endocrine changes, including hypothalamic-pituitary-adrenal axis and antidiuretic hormone alterations, are common post-TBI.
  • Approximately 30% of children experience hypopituitarism up to 5 years after injury.
  • Growth hormone deficiency and pubertal disturbances are most frequent, but other deficiencies (ACTH, diabetes insipidus, hypothyroidism, hyperprolactinemia) can occur.

Conclusions:

  • Pediatric TBI can affect all hormonal axes, with growth hormone and pubertal development most commonly impacted.
  • Transient and permanent hypopituitarism are significant risks following childhood TBI.
  • Serial endocrine screening is crucial for early detection and management of hormonal deficiencies to support normal growth and development.

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