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Related Concept Videos

Traumatic Brain Injury l: Introduction01:28

Traumatic Brain Injury l: Introduction

DefinitionTraumatic brain injury, or TBI, is a disturbance of normal brain function induced by an external mechanical force, such as a direct blow to the head or a penetrating injury. It can affect both brain structure and function, producing a wide range of clinical outcomes. TBI is a heterogeneous condition, meaning its effects may differ based on the type, location, and severity of the injury.Basis of ClassificationTBI is classified based on severity, injury mechanism, or pathophysiology. In...
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Early Ischemia and Ionic ImbalanceWithin minutes of spinal cord injury, a secondary cascade begins, progressing over hours to weeks. Vascular damage reduces blood flow, causing ischemia and mitochondrial dysfunction. ATP depletion leads to ion pump failure, membrane depolarization, sodium influx, potassium efflux, and water accumulation, resulting in cellular swelling. Increased intracellular calcium further disrupts mitochondria and accelerates cellular injury.Excitotoxicity and Neuronal...
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Cerebral Edema ll: Pathophysiology

Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...
Increased Intracranial Pressure ll: Pathophysiology01:29

Increased Intracranial Pressure ll: Pathophysiology

Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...
Major Hormones and Their Functions01:27

Major Hormones and Their Functions

Hormones, the biochemical messengers produced by endocrine glands, are pivotal in regulating bodily functions and maintaining homeostasis. Each hormone's balance is crucial; imbalances can lead to significant physiological disruptions. Major hormones include oxytocin, cortisol, epinephrine, estrogen, testosterone, thyroxine, growth hormone, insulin, and glucagon.
Oxytocin, produced in the hypothalamus and released by the pituitary gland, plays a role in social bonding, childbirth, and lactation.

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A Pediatric Concussion Model in Mice: Closed Head Injury with Long-Term Disorders (CHILD)
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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
Summary

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

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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.