Hormonal problems caused by damage to the pituitary gland are considered common in traumatic brain injury. However, reports of rates of pituitary gland impairment after traumatic brain injury have varied from 15-90%. Researchers from the Netherlands recently suggested that this variation could be due to differences in diagnostic criteria, in the type of tests given, in the severity of the injury, or even in the time of day the test is given. They reviewed data from 931 patients to determine what exactly created such discrepancies.
Several factors were found that could lead to misdiagnosis of endocrine problems after traumatic brain injury. For instance, body mass index could affect rates of growth hormone insufficiency. The age of a woman could affect levels of LH and FSH levels. The amount of time after injury also made a difference in diagnosis. Several studies used different sets of cutoff rates and diagnostic guidelines.
Given that there may be a high incidence of pituitary-related hormonal problems after traumatic brain injury, and that these problems may contribute to poor recovery, it is important that clinicians carefully consider all the potential factors that could lead to a misdiagnosis. Additionally, tests and diagnostic guidelines should be reviewed to ensure they are sensitive and reliable.
Kokshoorn NE, Wassenaar MJE, Biermasz NR, et al. Hypopituitarism following traumatic brain injury: Prevalence is affected by the use of different dynamic tests and different normal values. European Journal of Endocrinology. (January 2010).