Post-traumatic Hypopituitarism in Children and Adolescents

Czech version

Authors: J. Zapletalová ¹; D. Aleksijević ¹; V. Smolka ¹; D. Krahulík ²; Z. Fryšák ³
Authors‘ workplace: LF UP a FN Olomouc Dětská klinika ¹; LF UP a FN Olomouc Neurochirurgická klinika ²; LF UP a FN Olomouc III. interní klinika ³
Published in: Cesk Slov Neurol N 2010; 73/106(4): 398-401
Category: Review Article

Overview

Hypothalamic-pituitary axis failure significantly affects morbidity in subjects after moderate to severe brain injury. Post-mortem histopathological studies have demonstrated the vulnerability of the hypothalamus and pituitary to external injury. Endocrine changes in the first hours and days after an accident are usually transient and comparable to those observed at other critical stages (known as “sick syndrome”). Frequent and expected complications usually include temporary disturbances of water metabolism. These changes may take the form of diabetes insipidus and can be identified as inappropriate antidiuretic hormone secretion syndrome. Both of these are consequences of transient neuropituitary dysfunction. Hormonal changes that occur months or even years after an accident were once considered exceptional. This view has changed over the past decade in view of the results of several studies in adults that give the prevalence of post-traumatic hypopituitarism at between 23 and 69%. Substantially less is known about the prevalence and implications for neuro-endocrine dysfunction in the pediatric population compared to that in adults. Untreated hormonal disturbances may have significant and permanent impacts upon a child’s mental and physical development. This article provides basic information about trauma-induced hormonal dysfunction in children and adults.

Key words:
brain injury – post-traumatic hypopituitarism

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