ASSESSMENT OF NEUROENDOCRINE DYSFUNCTION FOLLOWING TRAUMATIC BRAIN INJURY

Posttraumatic neuroendocrine pathology may be a clinically significant complication following traumatic blain injury (TBI). Metabolic abnorm alities are described after TBI in two cases. A 21 year old male injur ed in a motor Vehicle accident admitted in a minimally responsive cond ition presented with fluctuating high sodium levels, undetectable seru m testosterone, and depressed cortisol and thyroid function. Imaging r evealed near complete avulsion of the pituitary stalk leading to panhy popituitarism. A 38 year old male admitted for occipital skull fractur es and brain contusions presented with hyponatremia and low serum test osterone. Both patients required hormonal replacement and correction o f electrolyte abnormalities. A screening protocol adapted for selected patients at risk for endocrine problems is described. While neuroendo crine screening is not advocated in all TBI patients, physicians shoul d be aware of the importance of neuroendocrine dysfunction following T BI.