Traumatic Injury to the Brain and Endocrine Evaluation of the Anterior Pituitary a Year After the Event (The TRIBE Study)

Recent clinical studies have shown that moderate and severe traumatic brain injury (TBI) is a common cause of hypopituitarism. Mild TBI has also been associated with hypopituitarism, which since it is often not evaluated, the hypopituitar-ism may remain under diagnosed. In this study we aimed at determining the clinical and hor-monal profile of mild TBI patients admitted a year after their injury. Materials & Methods: The sample was a descrip-tive, prospective cohort in a tertiary hospital. A hypopituitarism clinical evaluation form was used to evaluate the patients for signs and symp-toms of hypopituitarism a year after mild TBI. Pituitary hormonal function was tested a year af-ter their injury for IGF-1, FT4, TSH, cortisol, LH, FSH and testosterone. Results: Six male patients with mild TBI were studied. Mean age was 27  8 years old. All of them had intra-cranial hemorrhage on CT-scan and five underwent emergency decompressive cranial surgery. Evaluation was done 481 ? 67 days after the event. Signs of hypopituitarism were not observed but symptoms of decreased vigor and weight gain was present in five of the six patients. IGF-1 was low in 33% (2/6) and tes-tosterone level was low in 17% (1/6).8 am cortisol levels were equivocal in 83% (5/6) but ACTH-stimulated cortisol values were normal. Thyroid function test were normal for all subjects. Conclusion: The most common symptoms were weight gain & decreased vigor. Signs of hypopi-tuitarism were not noted among the mild TBI pa-tients. Pituitary hormone testing revealed ab-normalities in the somatotrophic & gonado-trophic axes.