Function tests on the neuroendocrine hypothalamo-pituitary system following acute midbrain syndrome, with special reference to computertomographical and magnetic resonance imaging results

Abstract

Seventeen patients underwent a neuroendocrinological function test at a mean 6.3 years following a severe craniocerebral trauma (CCT) accompanied by midbrain syndrome. An insulin hypoglycaemia test (IHT) and the combined pituitary anterior lobe test (CPALT) were applied. Whereas the IHT as maximum stimulator of the hypothalamo-pituitary system (HPS) showed an adequate reserve capacity, the CPALT yielded a partial limitation of the secretion dynamic in the somatotropic, adrenocorticotropic axis as well as a dysfunction in the FSH secretion. Neuroradiological tests could not establish substantial injury in the regio hypothalamica in any patient.

Hypothalamic-pituitary-adrenal axis dysfunction in critically ill patients with traumatic brain injury: Incidence, pathophysiology, and relationship to vasopressor dependence and peripheral interleukin-6 levels*

“…Thus, 30% to 80% of TBI victims have been found to develop pituitary hormone deficiencies in a variety of combinations (1)(2)(3)(4)(5)(6). So far, gonadal (7)(8)(9) and thyroid axes (10 -13) functions along with adequacy of growth hormone secretion (11)(12)(13)(14) have been extensively investigated.…”

Early and Longtime Modifications of Temperature Regulation after Severe Head Injury

“…We were not able to stimulate the anterior pituitary lobe with releasing hormones. In a study by Lenzen, 22 who investigated the endocrine sequelae of a severe head injury, the stimulated values of cortisol, growth hormone, follicle‐stimulating hormone and prolactin were reduced. The pituitary‐thyroid‐axis, however, was not disturbed.…”

Anterior Pituitary Hormone Abnormalities following Traumatic Brain Injury

“…normal values of hormones were not validated in the intensive care unit (ICU) setting, which makes the interpretation of basal hormones even more difficult. Lenzen et al (1993) reported decreased GH and cortisol responses to GHRH and CRH, respectively, in 17 patients with severe head injury compared to healthy controls but no impairment of GH and cortisol in the insulintolerance test (ITT). Kelly et al (2000) studied pituitary function in 22 patients with moderate to severe head injury and a matched control group.…”