A case of bilateral adrenal haemorrhage following traumatic brain injury

We report the case of a 57-year-old man who sustained an isolated severe traumatic brain injury (TBI). During his admission to the intensive care unit (ICU), he developed marked arterial hypotension of unclear cause. Eventually, the presence of renal angle tenderness on clinical examination and a low random-cortisol level lead to the suspicion of primary adrenal insufficiency. A computed tomography scan of his abdomen demonstrated new bilateral adrenal haemorrhages. This diagnosis is not unlikely to be missed, as symptoms and laboratory tests are often nonspecific.