Mild traumatic brain injury and immediate hypopituitarism in children

Detalhes bibliográficos
Autor(a) principal: Nordon, David Gonçalves
Data de Publicação: 2012
Outros Autores: Guimarães, Rodrigo Rejtman, Nigri, Alcinda Aranha, Esposito, Sandro Blasi
Tipo de documento: Artigo
Idioma: por
eng
Título da fonte: Scientia Medica (Porto Alegre. Online)
Texto Completo: https://revistaseletronicas.pucrs.br/scientiamedica/article/view/9999
Resumo: AIMS: Traumatic brain injury is a common and costly trauma that may lead to hypopituitarism. Its complications may have great impact on public health, especially in children. This study evaluates the prevalence of immediate hypopituitarism in children who suffered mild traumatic brain injury. METHODS: Children who were admitted in the emergency service of Unidade Regional de Emergência – Conjunto Hospitalar de Sorocaba due to traumatic brain injury were evaluated for the study. Every patient underwent a head computed tomography at admittance and was classified according to the Glasgow Coma Scale, being traumatic brain injury graded in severe (12). Those whose parents or guardians agreed to participate and presented mild trauma were included in the study and invited to perform a neuroendocrinological evaluation. RESULTS: Sixty-eight children were admitted with traumatic brain injury, and 21 agreed to participate. Five patients did not perform the urine and blood exams, two had a moderate TBI, and one had a severe TBI, and therefore were excluded from data analysis. Among the 13 patients whose exams were performed in less than 48 hours from the trauma, five (38.5%) presented hormonal alterations, respectively: single thyroid-stimulant hormone (TSH) elevation, single insuline-like growth factor 1 (IGF-1) elevation, single cortisol elevation, combined folicule-stimulant hormone (FSH) and prolactin elevation, and combined TSH and FSH elevation. None presented symptoms of hypopituitarism. There was no association between head image alterations and hypopituitarism. CONCLUSIONS: The results found in this study lead to probably little significant endocrine dysfunctions, as such hormonal increases may be related to acute trauma response. Considering the literature and the results, it is possible to speculate that the relationship of traumatic brain injury with hypopituitarism in children is different from adults. .
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spelling Mild traumatic brain injury and immediate hypopituitarism in childrenTrauma cranioencefálico leve e hipopituitarismo imediato em crianças [Resumo em Português]CRANIOCEREBRAL TRAUMABRAIN INJURIESHEAD INJURIESTHYROID GLANDHYPOPITUITARISMCHILDEMERGENCY MEDICINE.TRAUMATISMOS CRANIOCEREBRAISTRAUMATISMOS ENCEFÁLICOSTRAUMA CRANIANOTIREÓIDEHIPOPITUITARISMOCRIANÇAMEDICINA DE EMERGÊNCIA.AIMS: Traumatic brain injury is a common and costly trauma that may lead to hypopituitarism. Its complications may have great impact on public health, especially in children. This study evaluates the prevalence of immediate hypopituitarism in children who suffered mild traumatic brain injury. METHODS: Children who were admitted in the emergency service of Unidade Regional de Emergência – Conjunto Hospitalar de Sorocaba due to traumatic brain injury were evaluated for the study. Every patient underwent a head computed tomography at admittance and was classified according to the Glasgow Coma Scale, being traumatic brain injury graded in severe (12). Those whose parents or guardians agreed to participate and presented mild trauma were included in the study and invited to perform a neuroendocrinological evaluation. RESULTS: Sixty-eight children were admitted with traumatic brain injury, and 21 agreed to participate. Five patients did not perform the urine and blood exams, two had a moderate TBI, and one had a severe TBI, and therefore were excluded from data analysis. Among the 13 patients whose exams were performed in less than 48 hours from the trauma, five (38.5%) presented hormonal alterations, respectively: single thyroid-stimulant hormone (TSH) elevation, single insuline-like growth factor 1 (IGF-1) elevation, single cortisol elevation, combined folicule-stimulant hormone (FSH) and prolactin elevation, and combined TSH and FSH elevation. None presented symptoms of hypopituitarism. There was no association between head image alterations and hypopituitarism. CONCLUSIONS: The results found in this study lead to probably little significant endocrine dysfunctions, as such hormonal increases may be related to acute trauma response. Considering the literature and the results, it is possible to speculate that the relationship of traumatic brain injury with hypopituitarism in children is different from adults. .OBJETIVOS: O trauma cranioencefálico é um trauma comum e dispendioso que pode levar a hipopituitarismo. Suas complicações podem ter grande impacto na saúde pública, especialmente em crianças. Este estudo avalia a prevalência de hipopituitarismo imediato em crianças que sofreram lesão cerebral traumática leve. MÉTODOS: Foram avaliadas para o estudo crianças admitidas no serviço de emergência da Unidade Regional de Emergência - Conjunto Hospitalar de Sorocaba devido a um trauma cranioencefálico. Cada paciente foi submetido a uma tomografia computadorizada na admissão e classificado pela Escala de Coma de Glasgow, sendo a lesão cerebral classificada em grave ( 12). Aqueles cujos pais ou responsáveis concordaram em participar e apresentavam a forma leve de trauma cranioencefálico foram incluídos no estudo e convidados a realizar uma avaliação neuroendocrinológica. RESULTADOS: Sessenta e oito crianças foram internadas com traumatismo cranioencefálico e 21 concordaram em participar. Cinco pacientes não realizaram os exames de sangue e urina, dois tinham a forma moderada e um tinha a forma grave de trauma cranioencefálico, sendo excluídos da análise. Entre as 13 crianças cujos exames foram feitos dentro das primeiras 48 horas após o trauma, cinco (38,5%) apresentaram alterações hormonais, respectivamente: somente elevação de hormônio estimulante da tireoide (TSH); somente elevação de fator de crescimento insulina-símile 1 (IGF-1); somente elevação de cortisol; elevação de hormônio folículo estimulante (FSH) combinada à elevação de prolactina; e elevação de TSH combinada à elevação de FSH. Nenhum dos pacientes apresentou sintomas de hipopituitarismo. Não houve associação entre alterações de neuroimagem e hipopituitarismo. CONCLUSÕES: Os resultados deste estudo apontam para disfunções endócrinas provavelmente pouco importantes, já que algumas das alterações encontradas podem estar relacionadas à resposta ao trauma agudo. Considerando a literatura e os resultados, é possível especular que a relação do trauma cranioencefálico com hipopituitarismo em crianças é diferente dos adultos.Editora da PUCRS - ediPUCRS2012-07-27info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://revistaseletronicas.pucrs.br/scientiamedica/article/view/9999Scientia Medica; Vol. 22 No. 2 (2012); 86-90Scientia Medica; v. 22 n. 2 (2012); 86-901980-61081806-5562reponame:Scientia Medica (Porto Alegre. Online)instname:Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)instacron:PUC_RSporenghttps://revistaseletronicas.pucrs.br/scientiamedica/article/view/9999/8157https://revistaseletronicas.pucrs.br/scientiamedica/article/view/9999/8158Nordon, David GonçalvesGuimarães, Rodrigo RejtmanNigri, Alcinda AranhaEsposito, Sandro Blasiinfo:eu-repo/semantics/openAccess2013-07-15T18:44:36Zoai:ojs.revistaseletronicas.pucrs.br:article/9999Revistahttps://revistaseletronicas.pucrs.br/scientiamedica/PUBhttps://revistaseletronicas.pucrs.br/scientiamedica/oaiscientiamedica@pucrs.br || editora.periodicos@pucrs.br1980-61081806-5562opendoar:2013-07-15T18:44:36Scientia Medica (Porto Alegre. Online) - Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)false
dc.title.none.fl_str_mv Mild traumatic brain injury and immediate hypopituitarism in children
Trauma cranioencefálico leve e hipopituitarismo imediato em crianças [Resumo em Português]
title Mild traumatic brain injury and immediate hypopituitarism in children
spellingShingle Mild traumatic brain injury and immediate hypopituitarism in children
Nordon, David Gonçalves
CRANIOCEREBRAL TRAUMA
BRAIN INJURIES
HEAD INJURIES
THYROID GLAND
HYPOPITUITARISM
CHILD
EMERGENCY MEDICINE.
TRAUMATISMOS CRANIOCEREBRAIS
TRAUMATISMOS ENCEFÁLICOS
TRAUMA CRANIANO
TIREÓIDE
HIPOPITUITARISMO
CRIANÇA
MEDICINA DE EMERGÊNCIA.
title_short Mild traumatic brain injury and immediate hypopituitarism in children
title_full Mild traumatic brain injury and immediate hypopituitarism in children
title_fullStr Mild traumatic brain injury and immediate hypopituitarism in children
title_full_unstemmed Mild traumatic brain injury and immediate hypopituitarism in children
title_sort Mild traumatic brain injury and immediate hypopituitarism in children
author Nordon, David Gonçalves
author_facet Nordon, David Gonçalves
Guimarães, Rodrigo Rejtman
Nigri, Alcinda Aranha
Esposito, Sandro Blasi
author_role author
author2 Guimarães, Rodrigo Rejtman
Nigri, Alcinda Aranha
Esposito, Sandro Blasi
author2_role author
author
author
dc.contributor.author.fl_str_mv Nordon, David Gonçalves
Guimarães, Rodrigo Rejtman
Nigri, Alcinda Aranha
Esposito, Sandro Blasi
dc.subject.por.fl_str_mv CRANIOCEREBRAL TRAUMA
BRAIN INJURIES
HEAD INJURIES
THYROID GLAND
HYPOPITUITARISM
CHILD
EMERGENCY MEDICINE.
TRAUMATISMOS CRANIOCEREBRAIS
TRAUMATISMOS ENCEFÁLICOS
TRAUMA CRANIANO
TIREÓIDE
HIPOPITUITARISMO
CRIANÇA
MEDICINA DE EMERGÊNCIA.
topic CRANIOCEREBRAL TRAUMA
BRAIN INJURIES
HEAD INJURIES
THYROID GLAND
HYPOPITUITARISM
CHILD
EMERGENCY MEDICINE.
TRAUMATISMOS CRANIOCEREBRAIS
TRAUMATISMOS ENCEFÁLICOS
TRAUMA CRANIANO
TIREÓIDE
HIPOPITUITARISMO
CRIANÇA
MEDICINA DE EMERGÊNCIA.
description AIMS: Traumatic brain injury is a common and costly trauma that may lead to hypopituitarism. Its complications may have great impact on public health, especially in children. This study evaluates the prevalence of immediate hypopituitarism in children who suffered mild traumatic brain injury. METHODS: Children who were admitted in the emergency service of Unidade Regional de Emergência – Conjunto Hospitalar de Sorocaba due to traumatic brain injury were evaluated for the study. Every patient underwent a head computed tomography at admittance and was classified according to the Glasgow Coma Scale, being traumatic brain injury graded in severe (12). Those whose parents or guardians agreed to participate and presented mild trauma were included in the study and invited to perform a neuroendocrinological evaluation. RESULTS: Sixty-eight children were admitted with traumatic brain injury, and 21 agreed to participate. Five patients did not perform the urine and blood exams, two had a moderate TBI, and one had a severe TBI, and therefore were excluded from data analysis. Among the 13 patients whose exams were performed in less than 48 hours from the trauma, five (38.5%) presented hormonal alterations, respectively: single thyroid-stimulant hormone (TSH) elevation, single insuline-like growth factor 1 (IGF-1) elevation, single cortisol elevation, combined folicule-stimulant hormone (FSH) and prolactin elevation, and combined TSH and FSH elevation. None presented symptoms of hypopituitarism. There was no association between head image alterations and hypopituitarism. CONCLUSIONS: The results found in this study lead to probably little significant endocrine dysfunctions, as such hormonal increases may be related to acute trauma response. Considering the literature and the results, it is possible to speculate that the relationship of traumatic brain injury with hypopituitarism in children is different from adults. .
publishDate 2012
dc.date.none.fl_str_mv 2012-07-27
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://revistaseletronicas.pucrs.br/scientiamedica/article/view/9999
url https://revistaseletronicas.pucrs.br/scientiamedica/article/view/9999
dc.language.iso.fl_str_mv por
eng
language por
eng
dc.relation.none.fl_str_mv https://revistaseletronicas.pucrs.br/scientiamedica/article/view/9999/8157
https://revistaseletronicas.pucrs.br/scientiamedica/article/view/9999/8158
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Editora da PUCRS - ediPUCRS
publisher.none.fl_str_mv Editora da PUCRS - ediPUCRS
dc.source.none.fl_str_mv Scientia Medica; Vol. 22 No. 2 (2012); 86-90
Scientia Medica; v. 22 n. 2 (2012); 86-90
1980-6108
1806-5562
reponame:Scientia Medica (Porto Alegre. Online)
instname:Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)
instacron:PUC_RS
instname_str Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)
instacron_str PUC_RS
institution PUC_RS
reponame_str Scientia Medica (Porto Alegre. Online)
collection Scientia Medica (Porto Alegre. Online)
repository.name.fl_str_mv Scientia Medica (Porto Alegre. Online) - Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)
repository.mail.fl_str_mv scientiamedica@pucrs.br || editora.periodicos@pucrs.br
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