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Traumatic Brain Injury and Growth Hormone Deficiency

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Growth Hormone Deficiency


The most common isolated hormonal deficiency after traumatic brain injury (TBI) in both children and adults is growth hormone deficiency (GHD). Adequate evaluation of the growth hormone (GH) axis after TBI in children and adults is evolving. Despite the inherent limitations to this field of research, available data depict the importance of evaluating TBI patients for GHD. GHD affects not only linear growth, but may influence patients’ overall well-being, general metabolism, and cognition as manifested clinically through symptoms such as fatigue and memory problems. Pituitary function after TBI undergoes remarkable variation over time; dissimilar methodologies could account for marked variations in prevalence of GHD. The lack of a gold standard test for GHD raises questions regarding the true occurrence of GHD after TBI. Although somewhat controversial, most recent well-designed studies in children argue in favor of performing dynamic GH tests only in patients with slow growth after appropriate follow-up. All patients with documented severe GHD are candidates for GH replacement therapy.

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  1. Rutland-Brown W, Langlois JA, Xi YL. Incidence of traumatic brain injury in the United States, 2003. J Head Trauma Rehabil. 2006;21:544–8.

    Article  PubMed  Google Scholar 

  2. Zaloshnja E, Miller T, Langlois JA, Selassie AW. Prevalence of long-term disability from traumatic brain injury in the civilian population of the United States, 2005. J Head Trauma Rehabil. 2008;23:394–400.

    Article  PubMed  Google Scholar 

  3. Cyran E. Hypophysenschadigung durch Schadelbasisfraktur. Dtsch Med Wschr. 1918;44:1261.

    Google Scholar 

  4. Schneider HJ, Schneider M, Saller B, Petersenn S, Uhr M, et al. Prevalence of anterior pituitary insufficiency 3 and 12 months after traumatic brain injury. Eur J Endocrinol. 2006;154:259–65.

    Article  CAS  PubMed  Google Scholar 

  5. Wachter D, Gündling K, Oertel MF, Stracke H, Böker DK. Pituitary insufficiency after traumatic brain injury. J Clin Neurosci. 2009;16:202–8.

    Article  CAS  PubMed  Google Scholar 

  6. Salehi F, Kovacs K, Scheithauer BW, Pfeifer EA, Cusimano M. Histologic study of the human pituitary gland in acute traumatic brain injury. Brain Inj. 2007;21:651–6.

    Article  PubMed  Google Scholar 

  7. Benvenga S, Campenni A, Ruggeri RM, Trimarchi F. Clinical review 113: hypopituitarism secondary to head trauma. J Clin Endocrinol Metab. 2000;85:1353–61.

    Article  CAS  PubMed  Google Scholar 

  8. Tanriverdi F, De Bellis A, Battaglia M, Bellastella G, Bizzarro A, et al. Investigation of antihypothalamus and antipituitary antibodies in amateur boxers: is chronic repetitive head trauma-induced pituitary dysfunction associated with autoimmunity? Eur J Endocrinol. 2010;162:861–7.

    Article  CAS  PubMed  Google Scholar 

  9. White JR, Farukhi Z, Bull C, Christensen J, Gordon T, Paidas C, Nichols DG. Predictors of outcome in severely head-injured children. Crit Care Med. 2001;29:534–40.

    Article  CAS  PubMed  Google Scholar 

  10. Gasco V, Prodam F, Pagano L, Grottoli S, Belcastro S, et al. Hypopituitarism following brain injury: when does it occur and how best to test? Pituitary. 2012;15:20–4.

    Article  PubMed  Google Scholar 

  11. Schneider HJ, Kreitschmann-Andermahr I, Ghigo E, Stalla GK, Agha A. Hypothalamopituitary dysfunction following traumatic brain injury and aneurysmal subarachnoid hemorrhage: a systematic review. JAMA. 2007;298:1429–38.

    Article  CAS  PubMed  Google Scholar 

  12. Ioachimescu AG, Hampstead BM, Moore A, Burgess E, Phillips LS. Growth hormone deficiency after mild combat-related traumatic brain injury. Pituitary. 2014. doi:10.1007/s11102-014-0606-5.

    Google Scholar 

  13. Kokshoorn NE, Smit JW, Nieuwlaat WA, Tiemensma J, Bisschop PH, Groote Veldman R, et al. Low prevalence of hypopituitarism after traumatic brain injury: a multicenter study. Eur J Endocrinol. 2011;165:225–31.

    Article  CAS  PubMed  Google Scholar 

  14. Klose M, Stochholm K, Janukonyte J, Lehman Christensen L, Frystyk J, Andersen M, et al. Prevalence of posttraumatic growth hormone deficiency is highly dependent on the diagnostic set-up: results from The Danish National Study on Posttraumatic Hypopituitarism. J Clin Endocrinol Metab. 2014;99:101–10.

    Article  CAS  PubMed  Google Scholar 

  15. Bellone S, Einaudi S, Caputo M, Prodam F, Busti A, Belcastro S, et al. Measurement of height velocity is a useful marker for monitoring pituitary function in patients who had traumatic brain injury. Pituitary. 2013;16:499–506.

    Article  CAS  PubMed  Google Scholar 

  16. Personnier C, Crosnier H, Meyer P, Chevignard M, Flechtner I, Boddaert N, et al. Prevalence of pituitary dysfunction after severe traumatic brain injury in children and adolescents: a large prospective study. J Clin Endocrinol Metab. 2014;99:2052–60.

    Article  CAS  PubMed  Google Scholar 

  17. Heather NL, Jefferies C, Hofman PL, Derraik JG, Brennan C, Kelly P, et al. Permanent hypopituitarism is rare after structural traumatic brain injury in early childhood. J Clin Endocrinol Metab. 2012;97:599–604.

    Article  CAS  PubMed  Google Scholar 

  18. Khadr SN, Crofton PM, Jones PA, Wardhaugh B, Roach J, Drake AJ, et al. Evaluation of pituitary function after traumatic brain injury in childhood. Clin Endocrinol (Oxf). 2010;73:637–43.

    Article  CAS  Google Scholar 

  19. Salomon-Estebanez MA, Grau G, Vela A, Rodriguez A, Morteruel E, Castaño L, et al. Is routine endocrine evaluation necessary after paediatric traumatic brain injury? J Endocrinol Invest. 2014;37:143–8.

    Article  CAS  PubMed  Google Scholar 

  20. Nyberg F. The role of the somatotropic axis in neuroprotection and neuroregeneration of the addictive brain. Int Rev Neurobiol. 2009;88:399–427.

    Article  CAS  PubMed  Google Scholar 

  21. Nyberg F. Growth hormone and cognitive function. Nat Rev Endocrinol. 2013;9:357–65.

    Article  CAS  PubMed  Google Scholar 

  22. Deijen JB, de Boer H, van der Veen EA. Cognitive changes during growth hormone replacement in adult men. Psychoneuroendocrinology. 1998;23:45–55.

    Article  CAS  PubMed  Google Scholar 

  23. Maric NP, Doknic M, Pavlovic D, Pekic S, Stojanovic M, et al. Psychiatric and neuropsychological changes in growth hormone-deficient patients after traumatic brain injury in response to growth hormone therapy. J Endocrinol Invest. 2010;33:770–5.

    Article  CAS  PubMed  Google Scholar 

  24. Devesa J, Reimunde P, Devesa P, Barbera M, Arce V. Growth hormone (GH) and brain trauma. Horm Behav. 2013;63:331–44.

    Article  CAS  PubMed  Google Scholar 

  25. Birzniece V, Khaw CH, Nelson AE, Meinhardt U, Ho KK. A critical evaluation of bioimpedance spectroscopy analysis in estimating body composition during GH treatment: comparison with bromide dilution and dual X-ray absorptiometry. Eur J Endocrinol. 2015;172:21–8.

    Article  CAS  PubMed  Google Scholar 

  26. Molitch ME, Clemmons DR, Malozowski S, Merriam GR, Vance ML, Endocrine Society. Evaluation and treatment of adult growth hormone deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96:1587–609.

    Article  CAS  PubMed  Google Scholar 

  27. Marina D, Klose M, Nordenbo A, Liebach A, Feldt-Rasmussen U. Early endocrine alterations reflect prolonged stress and relate to one year functional outcome in patients with severe brain injury. Eur J Endocrinol. 2015;172:813–22.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Alan D. Rogol .

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Richmond, E., Rogol, A.D. (2016). Traumatic Brain Injury and Growth Hormone Deficiency. In: Cohen, L. (eds) Growth Hormone Deficiency. Springer, Cham.

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