Keywords
Traumatic Brain Injury
Pituitary Dysfunction
How to Cite
Copyright © | All rights reserved.
The journal holds the exclusive copyright for the publication of this article under the terms of Brazilian law 9610/98.
Partial reproduction
The use of parts of the texts, figures and questionnaire of the article is free, being mandatory the citation of the authors and journal.
Total reproduction
It is expressly prohibited and must be authorized by the journal.
Abstract
Objective: Investigate the relationship between TBI and Hypopituitarism. Methods: This is an integrative review of the literature present in the PUBMED and VHL virtual libraries, using the following descriptors indexed by Decs/Bireme: ''TBI'', ''Hypopituitarism'', ''Pituitary gland''; using the Boolean operator AND between them. A total of 37 articles were found, using the filter of scientific productions from the last 5 years, in Portuguese, English and Spanish. After reading the articles, 18 were excluded for deviating from the highlighted theme and duplicity, and, finally, 19 works were selected. Final considerations: The results showed that symptoms such as fatigue, cognitive problems, insomnia and post-traumatic stress disorder are common after mild TBI. Growth hormone deficiency (GHD) was the most prevalent hormonal dysfunction. The clinical presentation varies depending on the number and type of pituitary axes affected, the severity of the hormonal deficiency and the time between the onset of hypopituitarism and diagnosis and treatment. Conclusion: It is concluded that it is essential to develop protocols and screening methods to evaluate patients after TBI, both in the acute and chronic phases, and to promote continuous studies on this relationship due to the potential serious health consequences resulting from the neuroendocrine process.
References
AGHA A, et al. Growth hormone deficiency after traumatic brain injury: frequency, pathophysiology, clinical consequences, and treatment outcomes. Journal of Neurotrauma, 2019; 36 (12): 1743-1754..
ALEXANDRAKI KI e GROSSMAN AB. Management of Hypopituitarism. Journal of Medicine, 2019; 8(12): 2155.
APPELBAUM RD, et al. Penetrating brain injury with hypopituitarism. Trauma Case Reports, 2022; 38: 100628.
AUGUSTO C, et al. Impacto das gonadotropinas e do hormônio do crescimento na função sexual e na saúde metabólica. Revista Brasileira de Endocrinologia e Metabolismo, 2021; 65(4): 456-467.
BENSALAH M, et al. Prevalence of hypopituitarism and quality of life in survivors of post‐traumatic brain injury. Endocrinology, Diabetes & Metabolism, 2020; 3(3).
BRIET C, et al. Should We Assess Pituitary Function in Children After a Mild Traumatic Brain Injury? A Prospective Study. Frontiers in Endocrinology, 2019; 10.
CARMONA CR, et al. Hipopituitarismo postraumatismo encefalocraneano: revisión de la literatura y algoritmo de estudio y abordaje terapéutico. Revista Medica De Chile, 2020; 148(12): 1796–1805.
CASTELLANO AK, et al. Relationship between Anterior Pituitary Volume and IGF-1 Serum Levels in Soldiers with Mild Traumatic Brain Injury History. Medicine and Science in Sports and Exercise, 2022; 54(8): 1364–1370.
GANAPATHY KM e TADI P. Anatomy, Sphenoid Bone. StatPearls (Internet). Treasure Island, StatPearls Publishing, 2023.
GASCO V, et al. Traumatic Brain Injury as Frequent Cause of Hypopituitarism and Growth Hormone Deficiency: Epidemiology, Diagnosis, and Treatment. Frontiers in Endocrinology, 2021; 12.
HERALDO M, et al. Gestão do hipopituitarismo sob a ótica da Sociedade Brasileira de Endocrinologia e Metabolismo. Revista Brasileira de Endocrinologia, 2021; 65(3): 123-134.
HOHL A, et al. Avaliação tardia do eixo hipofisário-gonadal em pacientes adultos que sofreram traumatismo cranioencefálico grave. Arquivos Brasileiros de Endocrinologia & Metabologia, 2009; 53(8): 1012–1019.
HU B, et al. A Balanced Act: The Effects of GH–GHR–IGF1 Axis on Mitochondrial Function. Frontiers in Cell and Developmental Biology, 2021; 9.
JANUSZEWSKA GA, et al. Traumatic brain injuries induced pituitary dysfunction: a call for algorithms. Endocrine Connections, 2020; 9(5): R112–R123.
KGOSIDIALWA O, et al. Growth Hormone Deficiency Following Traumatic Brain Injury. International Journal of Molecular Sciences, 2029; 20(13); 3323.
LEÃO GM e GAUDÊNCIO TG. A Epidemiologia do Traumatismo Crânio-Encefálico: Um Levantamento Bibliográfico no Brasil. Revista Neurociências, 2013; 21(4): 589-598.
LEE J, et al. Experience of a Pituitary Clinic for US Military Veterans With Traumatic Brain Injury. Journal of the Endocrine Society, 2021; 5(4).
MAHAJAN C, et al. Endocrine Dysfunction After Traumatic Brain Injury: An Ignored Clinical Syndrome? Neurocritical Care, 2023.
MCLOUGHLIN J e SWANSON RL. Hypopituitarism After Mild Traumatic Brain Injury: A Case Report. Cureus, 2023.
MELE C, et al. Neuroinflammation and Hypothalamo-Pituitary Dysfunction: Focus of Traumatic Brain Injury. International Journal of Molecular Sciences, 2021; 22(5): 2686.
MORTÁGUA JC. Hipopituitarismo pós-traumático: revisão de casos clínicos e implicações para o tratamento. Revista de Neuroendocrinologia Clínica,2016; 14(2): 103-110.
NTALI G e TSAGARAKIS S. Traumatic brain injury induced neuroendocrine changes: acute hormonal changes of anterior pituitary function. Pituitary, 2019; 22(3): 283–295.
OLIVEIRA AMH e BARTKE A.Growth Hormone Deficiency: Health and Longevity. Endocrine Reviews, 2018; v. 40, n. 2, p. 575–601
ORTIZ JB, et al. Epidemiology of Pediatric Traumatic Brain Injury and Hypothalamic-Pituitary Disorders in Arizona. Frontiers in Neurology, 2020; 10.
RAO A, et al. Endocrine Abnormalities in Children With Traumatic Brain Injury at a Tertiary Care Center. Cureus, 2023.
RODRIGUES TP, et al. Bases fisiopatológicas do traumatismo crânioencefálico e insuficiência hipofisária pós-traumática. Biosaúde, 2008; 10(2): 129-146.
SALLEH MN, et al. Chronic Anterior Pituitary Dysfunction Following Traumatic Head Injury: Prospective Study in Hospital Sultanah Aminah Johor Bahru, Malaysia. Malaysian Journal of Medical Sciences, 30(1): 107-115.
SALVIO G, et al. Hypothalamic–Pituitary Diseases and Erectile Dysfunction. Journal of Clinical Medicine, 2021; 10(12): 2551.
SOUZA MT, et al. Integrative Review: What Is It? How to Do It? Einstein (São Paulo),2010; 8(1): 102-106.
TAN CL, et al. The screening and management of pituitary dysfunction following traumatic brain injury in adults: British Neurotrauma Group guidance. Journal of Neurology, Neurosurgery, and Psychiatry, 2017; 88(11): 971-981.
TAN CL e HUTCHINSON PJ. A neurosurgical approach to traumatic brain injury and post-traumatic hypopituitarism. Pituitary, 2018; 22(3): 332–337.
VIJAPUR SM, et al. Anti-Pituitary and Anti-Hypothalamus Autoantibody Associations with Inflammation and Persistent Hypogonadotropic Hypogonadism in Men with Traumatic Brain Injury. Journal of Neurotauma, 2020; 37(14): 1609-1626.
WEST AN, et al. Evidence Limitations in Determining Sexually Dimorphic Outcomes in Pediatric Post-Traumatic Hypopituitarism and the Path Forward. Frontiers in Neurology, 2020; v. 11.
WEXLER T, et al. Growth Hormone Deficiency following Traumatic Brain Injury in Pediatric and Adolescent Patients: Presentation, Treatment, and Challenges of Transitioning from Pediatric to Adult Services. Journal of Neurotrauma, 2023; 40(13-14): 1274–1285.
WEXLER, TL. Neuroendocrine Disruptions Following Head Injury. Current Neurology and Neuroscience Reports, 2023; 23(5): 213–224.
YUEN KCJ, et al. A consensus on optimization of care in patients with growth hormone deficiency and mild traumatic brain injury. Growth Hormone & IGF Research, 2022; 66: 101495.