Abstract

Early CT Signs of Pituitary Dysfunction Following Acute Traumatic Brain Injury

Author(s): Bin He, Wusong Tong, Jingsong Zeng, Ping Zheng

Objective:

In this study, we aimed to identify the characteristics of early head CT scan in patients with traumatic brain injury (TBI) and to evaluate the association of such changes with hypopituitarism (HPT) in TBI patients.

Methods:

A cohort of 230 TBI patients was enrolled and further grouped with or without HPT based on the secretion status of pituitary hormones at six months post injury. Data were analyzed and compared including different signs of the early head CT scan. Logistic regression analysis was used to show the risk factors related to HPT.

Results:

Our study included 106 (46.1%) TBI patients suffered from pituitary dysfunction and 124 TBI patients with normal pituitary function. The differences between HPT and non-HPT were statistically significant in the initial CT scans showing basal fracture, subarachnoid hemorrhage (SAH), brain contusion, epidural hematoma (EDH), subdural hematoma (SDH), and multiple hematoma as well as the midline shift (P<0.01). Logistic regression analysis showed that early CT scans with basal fracture, SAH and midline shift were strong predictors of HPT (P<0.01).

Conclusion:

For patients with the initial CT scan shows basal fracture, SAH, and midline shift, dynamic laboratory tests for pituitary hormones should be performed for detection of HPT as early as possible and the medical intervention would be enforced in time.