Biomaterial Database

Endocrine sequelae of traumatic brain injury in childhood. 2007

Carlo L Acerini, and Robert C Tasker

Department of Paediatrics, University of Cambridge, Cambridge, UK. cla22@cam.ac.uk

BACKGROUND Anterior pituitary hormone dysfunction may be an important feature of long-term morbidity in survivors of traumatic brain injury (TBI). The hypothalamic-pituitary structures are vulnerable to damage following head injury. Therefore, pituitary dysfunction, which may be detected months or years after injury, is now well recognised as a long-term consequence of TBI in adults. In contrast, little is known about this potential complication in children and adolescents. This article reviews the available paediatric data, which show that hypopituitarism may occur after both mild and severe TBI, although there is little published data on its incidence or prevalence within this age group. A recent analysis of the KIGS (Pfizer International Growth Study database) highlights very few registered cases of TBI-related growth hormone deficiency, suggesting that this may be either an uncommon or an overlooked phenomenon. Prospective studies will be needed to determine the incidence, natural history and response to hormone replacement of post-TBI-induced hypopituitarism in children. CONCLUSIONS Given the critical role of anterior pituitary hormones in the regulation of growth and pubertal and neurocognitive development in childhood, early detection of hormone abnormalities is vital. A multidisciplinary approach to follow-up and endocrine assessment is required for the long-term management and rehabilitation of children and adolescents who survive moderate to severe head injury.

UI	MeSH Term	Description	Entries
D007018	Hypopituitarism	Diminution or cessation of secretion of one or more hormones from the anterior pituitary gland (including LH; FOLLICLE STIMULATING HORMONE; SOMATOTROPIN; and CORTICOTROPIN). This may result from surgical or radiation ablation, non-secretory PITUITARY NEOPLASMS, metastatic tumors, infarction, PITUITARY APOPLEXY, infiltrative or granulomatous processes, and other conditions.	Adenohypophyseal Hyposecretion,Anterior Pituitary Hyposecretion Syndrome,Sheehan Syndrome,Simmonds Disease,Hyposecretion Syndrome, Anterior Pituitary,Hyposecretion, Adenohypophyseal,Pituitary Insufficiency,Postpartum Hypopituitarism,Postpartum Panhypopituitarism,Postpartum Pituitary Insufficiency,Sheehan's Syndrome,Simmonds' Disease,Disease, Simmonds,Hypopituitarism, Postpartum,Insufficiency, Pituitary,Panhypopituitarism, Postpartum,Pituitary Insufficiency, Postpartum,Sheehans Syndrome,Simmond's Disease,Syndrome, Sheehan,Syndrome, Sheehan's
D001930	Brain Injuries	Acute and chronic (see also BRAIN INJURIES, CHRONIC) injuries to the brain, including the cerebral hemispheres, CEREBELLUM, and BRAIN STEM. Clinical manifestations depend on the nature of injury. Diffuse trauma to the brain is frequently associated with DIFFUSE AXONAL INJURY or COMA, POST-TRAUMATIC. Localized injuries may be associated with NEUROBEHAVIORAL MANIFESTATIONS; HEMIPARESIS, or other focal neurologic deficits.	Brain Lacerations,Acute Brain Injuries,Brain Injuries, Acute,Brain Injuries, Focal,Focal Brain Injuries,Injuries, Acute Brain,Injuries, Brain,Acute Brain Injury,Brain Injury,Brain Injury, Acute,Brain Injury, Focal,Brain Laceration,Focal Brain Injury,Injuries, Focal Brain,Injury, Acute Brain,Injury, Brain,Injury, Focal Brain,Laceration, Brain,Lacerations, Brain
D002648	Child	A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL.	Children
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293	Adolescent	A person 13 to 18 years of age.	Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D015599	Trauma Severity Indices	Systems for assessing, classifying, and coding injuries. These systems are used in medical records, surveillance systems, and state and national registries to aid in the collection and reporting of trauma.	Trauma Severity Index,Trauma Severity Indexes,Index, Trauma Severity,Indexes, Trauma Severity,Indices, Trauma Severity,Severity Index, Trauma,Severity Indexes, Trauma,Severity Indices, Trauma
D015994	Incidence	The number of new cases of a given disease during a given period in a specified population. It also is used for the rate at which new events occur in a defined population. It is differentiated from PREVALENCE, which refers to all cases in the population at a given time.	Attack Rate,Cumulative Incidence,Incidence Proportion,Incidence Rate,Person-time Rate,Secondary Attack Rate,Attack Rate, Secondary,Attack Rates,Cumulative Incidences,Incidence Proportions,Incidence Rates,Incidence, Cumulative,Incidences,Person time Rate,Person-time Rates,Proportion, Incidence,Rate, Attack,Rate, Incidence,Rate, Person-time,Rate, Secondary Attack,Secondary Attack Rates
D042241	Early Diagnosis	Methods to determine in patients the nature of a disease or disorder at its early stage of progression. Generally, early diagnosis improves PROGNOSIS and TREATMENT OUTCOME.	Early Detection of Disease,Diagnosis, Early,Disease Early Detection
D020249	Hormone Replacement Therapy	Therapeutic use of hormones to alleviate the effects of hormone deficiency.	Replacement Therapy, Hormone,Therapy, Hormone Replacement,Hormone Replacement Therapies,Replacement Therapies, Hormone,Therapies, Hormone Replacement