Endocrinopathy and Dysautonomia

Traumatic brain injury (TBI) is associated with endocrinopathies affecting all major hypothalamic-pituitary hormone axes and dysautonomia due to injury to sympathetic structures, inhibitory networks, or the spinal cord. Identification and management of dysregulated hypothalamic-pituitary-adrenal axis, antidiuretic hormone, and thyroid function are critical to assess and manage in the acute phase. Growth hormone, thyroid hormone, gonadotropins, and cortisol should be monitored in the long-term as chronic deficiencies can lead to prolonged metabolic and cognitive adverse effects. Spinal cord injury is associated with spinal shock, which has a high degree of morbidity and mortality and must be identified early and addressed appropriately.