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Evaluation of pituitary function in cases with the diagnosis of pediatric mild traumatic brain injury:
Hakan Aylanç1, Filiz Tütüncüler2, Necdet Süt3
1Department of Pediatrics, School of Medicine, Trakya University, Edirne, Turkey.
Insights
Head trauma in children rarely causes pituitary dysfunction, but ongoing monitoring is recommended due to potential late-onset issues. This study assessed pituitary function in pediatric head injury patients.
Area of Science:
- Pediatric Endocrinology
- Neuroendocrinology
- Trauma Care
Background:
- Head trauma is a significant concern in children.
- Potential for pituitary dysfunction post-head trauma requires investigation.
- Understanding the impact on hormonal axes is crucial.
Purpose of the Study:
- To determine the occurrence of pituitary dysfunction after pediatric head trauma.
- To identify which pituitary axes are most affected.
- To correlate dysfunction with trauma severity and time since injury.
Main Methods:
- Evaluated 24 children with diagnosed head trauma for pituitary dysfunction.
- Measured various hormones including cortisol, thyroid hormones, prolactin, IGF-1, gonadotropins, and sex hormones after 12-hour fasting.
- Assessed Glasgow Coma Scale for trauma severity and recorded time since diagnosis.
Main Results:
- No pathological pituitary hormonal axis conditions were found in any patient.
- One child (4.2%) exhibited low basal cortisol levels.
- No hormonal deficiencies were identified in the study cohort.
Conclusions:
- Pituitary dysfunction following head trauma may manifest later, not just early on.
- Long-term outpatient follow-up is essential for children with head trauma.
- Continued monitoring can detect delayed onset of pituitary issues.
Background:
This study was to determine whether pituitary dysfunction occurs after head trauma in children or not and which axis is affected more; to define the association of pituitary dysfunction with the severity of head trauma and duration time after the diagnosis of head trauma.
Materials And Methods:
In this study, 24 children who were diagnosed with head trauma were evaluated regarding pituitary dysfunction. In all cases, after 12 h fasting, serum cortisol, fT3, fT4, thyroid-stimulating hormone, prolactin, insulin-like growth factor-1, serum sodium, urine density, follicle-stimulating hormone, luteinizing hormone, in female cases E2, in male cases, TT levels were determined.
Results:
Mean age of children was 9.5 ± 3.1 years, 14 children (58.3%) had mild, 9 children (37.5%) had moderate, and 1 children (4.2%) had severe head trauma according to the Glasgow coma scale. Mean duration time after head trauma was 29.4 ± 9.8 months. In all cases, no pathologic condition was determined in the pituitary hormonal axis. In one children (4.2%), low basal cortisol level was found. There were no children with hormonal deficiency in this study.
Conclusion:
Although pituitary dysfunction after head trauma may develop in the early period, some may present in the late period; therefore, all cases should be followed up at outpatient clinics for a longer period.
