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 adaequate 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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Anderson E, W Haymaker: Breakthroughs in hypothalamic and pituitary research Prog in Brain Research 41 (1) (1974)
Barreca T et al: Evaluation of anterior pituitary function in patients with posttraumatic diabetes insipidus. Clin Endocrin & Metabol 51 (6) (1980) 1279–1282
Crompton MR: Hypothalamic lesions following closed head injury. Brain 94 (1971) 165
Daniel PM, CS Treib: The pathology of the pituitary gland in head injury. In: Modern trends in Endocrinology 2nd series. Hoeber, New York (1961)
De Cherney et al: Effect of ovine Corticotropin releasing hormone administered during insulin induced hypoglycaemia on plasma ACTH and Cortisol. Clin Endocrin & Metabol 64 (1986) 1211–1218
Edwards OM et al: Posttraumatic hypopituitarism. Six cases and a review of the literature. Med 65 (1986) 281–290
Eisele R: Hypophyseal stalk rupture. Beitr zur gericht Med 30 (1973) 93–96
Feibel J, M Kelly, L Lee, P Woolf: Loss of adrenocortical suppression after acute brain injury: Role of increased intracranial pressure and brainstem function. Clin Endocrin & Metabol 57 (1983) 1245–1250
Glöckner R, B Franze: Morphologische Hypophysenveränderungen bei traumatischen Schädelbasisfrakturen mit und ohne Beteiligung der Sella turcica. Krimi & forens Wissen 43 (1981) 53–58
Harper CG, D Doyle, JH Adams, D Graham: Analysis of abnormalities in pituitary gland in non missile head injury: study of 100 consecutive cases. J Clin Path 39 (1986) 769–773
Hesselmann J, KJ Zülch: Vegetative und endokrine Symptome nach traumatischer Hypothalamusschädigung. Acta Neuroveg (Wien) 30 (1967) 251–260
Jambert S et al: Panhypopituitarism secondary to head trauma: evidence for a hypothalamic origin of the deficit. Acta Endocrin 93 (1980) 264–270
Jaursch-Hancke C et al: Anterior hypopituitarism secondary to closed head trauma. Acta Endocrin 111 Suppl 274 (1986) 143–144
Kornblum RN, RS Fischer: Pituitary lesions in cranio-cerebral injuries. Arch Path 88 (1969) 242–248
Laun A, Akute Hirnstammschäden und sekundäre Folgen der zerebralen Massenverschiebung. Eine computertomographisch-morphologische und klinische Untersuchung. Acta Neurochir Suppl 40 (1987) 29–56
Martin CR: Endocrine physiology. Oxford University Press, New York-Oxford 1985
Martin JB, S Reichlin: Clinical Neuroendocrinology. FA Davis Company, Philadelphia 1987
Paxson CL, DR Brown: Posttraumatic anterior hypopituitarism. Ped 57 (1975) 893
Pia HW: Primary and secondary hypothalamus and brain stem lesions. Adv Neurosurg 13 (1985) 217–235
Rudman et al: Suprahypophyseal hypogonadism and hypothyreoidism during prolonged coma after head trauma. J Clin Endocrin & Metabol 45 (1977) 747–754
Scoble JE, CWH Havard: Anosmia and isolated ACTH-deficiency following a road traffic accident. J Neurosurg 73 (1990) 453–454
Siegenthaler W: Klinische Pathophysiologie. Thieme Verlag, Stuttgart-New York 1987
Valenta LJ, DR de Feo: Posttraumatic hypopituitarism due to a hypothalamic lesion. Am Med 68 (1980) 614–617
Wanke R, E Kricke: Histologische Veränderungen der Hypophyse bei traumatischen Hirnschäden und Hirntumoren. Bruns' Beitrag 200 (1960) 165–175
Zülch KJ: Vegetative und psychische Syndrome bei umschriebenen traumatischen Zwischenhirnschädigungen und ihre Beurteilung im Gutachten. Zentralblatt für Neurochir 10 (1950) 73–97
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Lenzen, J., Hildebrand, G., Laun, A. et al. Function tests on the neuroendocrine hypothalamo-pituitary system following acute midbrain syndrome, with special reference to computertomographical and magnetic resonance imaging results. Neurosurg. Rev. 16, 183–187 (1993). https://doi.org/10.1007/BF00304325
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00304325