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Disfunción hipotalámico-pituitaria después de una lesión cerebral traumática y hemorragia subaracnoidea aneurismal:
Harald Jörn Schneider1, Ilonka Kreitschmann-Andermahr, Ezio Ghigo
1Neuroendocrinology Group, Max Planck Institute of Psychiatry, Munich, Germany. schneider@mpipsykl.mpg.de
JAMA
|September 27, 2007
Resumen
El hipopituitarismo es una complicación común después de una lesión cerebral traumática y hemorragia subaracnoidea, que afecta la calidad de vida. La detección temprana y el tratamiento son cruciales para mejores resultados de recuperación.
Área de la Ciencia:
- La neuroendocrinología en neuroendocrinología.
- Neurología Neurología.
- Medicina interna es la medicina interna de las enfermedades.
Sus antecedentes:
- La disfunción neuroendocrina es una complicación frecuente, pero poco diagnosticada, después de una lesión cerebral traumática (TBI) y una hemorragia subaracnoidea aneurysmal (aSAH).
- Esta secuela representa una condición grave, pero tratable, que afecta la recuperación del paciente.
Objetivo del estudio:
- Revisar la investigación existente sobre la disfunción hipotalomo-pituitaria después de TBI y aSAH.
- Comprender la historia natural y las implicaciones clínicas del hipopituitarismo postraumático.
Principales métodos:
- Se realizó una búsqueda sistemática de la literatura en la base de datos MEDLINE (2000-2007).
- Las palabras clave incluían TBI, aSAH y deficiencias específicas de la hormona pituitaria.
- Los datos de 19 estudios con 1137 pacientes se combinaron para calcular las tasas de prevalencia.
Principales resultados:
- La prevalencia combinada de hipopituitarismo fue del 27,5% después de TBI y del 47% después de ASAH.
- Se observó una mayor prevalencia en pacientes con LCT grave en comparación con casos leves/moderados.
- Las anomalías neuroendocrinas podrían ser transitorias o evolucionar con el tiempo, afectando la calidad de vida y la salud metabólica.
Conclusiones:
- El hipopituitarismo es una complicación prevalente después de TBI y aSAH.
- Contribuye significativamente a la morbilidad y puede afectar la recuperación después de una lesión cerebral.
- Se necesitan más investigaciones y atención clínica para esta condición subdiagnosticada.
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