NKffffffffbd5c103cX11d23fe3986 ·
30/04/2010 08:23
Warning: if your child injures his head, even if he or she doesn't lose consciousness, be alert for possible hormone problems afterwards. Hospitals and doctors will probably not warn you about it, but every head injury carries a risk of damaging the pituitary gland, which could mean any of the following symptoms, separately or together: failure to grow, loss of libido, loss of periods in a girl, impotence in a boy, infertility, depression, weight gain, fatigue and more. These effects may show immediately or develop years later. The good news is that missing hormones can be replaced.
If you think this may apply to your child, insist that an endocrinologist does a full check.
Our son had a serious head injury as a child from which he seemed to recover brilliantly. However he committed suicide at the age of 31 and we discovered after his death that he had been impotent, and far more deeply and frequently depressed than we knew (severe head injury survivors have a tripled or quadrupled risk of committing suicide). Then we discovered research showing that 20-30% of moderate/severe head injuries cause pituitary damage. The figure for mild injuries is less clear but the risk is well established. The reference to one systematic review of the evidence is Hypothalamopituitary Dysfunction Following Traumatic Brain Injury and Aneurysmal Subarachnoid Hemorrhage: A Systematic Review, Schneider et al, JAMA 2007
Review of 19 studies covering 1137 patients. Pooled prevalence 27.5% for TBI, 47% for SAH.
jama.ama-assn.org/cgi/content/full/298/12/1429
But simply googling 'hypopituitarism after traumatic brain injury' or 'neuroendocrine dysfunction after brain injury' will bring up a huge mass of studies. It is a disgrace that the National Institute for Clinical Excellence have not updated their guideline on head injury to include a warning about this, despite much correspondence from me. They are working on a separate guideline on the subject but this will not come out for years, and in the meantime thousands of people are at risk. There are 150,000 traumatic brain injuries a year, and 15% of them are moderate to severe.