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2009, Number 4

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Med Sur 2009; 16 (4)

Disfunción neuroendocrina secundaria a traumatismo craneoencefálico. Una nueva y vanguardista línea de investigación clínica de la Unidad de Terapia Intensiva

Carrillo ER, Castro PJF

Language: Spanish
References: 34
Page: 185-190
PDF size: 58.48 Kb.


ABSTRACT

Introduction. The neuroendocrine dysfunction secondary to Brain trauma injury (BTI) is a frequent but undiagnosed entity. The pathophysiological basis lies in hypotalamic-hypofisis dysfunction influencing the hormonal production evidenced clinically as: central hypotiroidism, hypogonadism, growth hormone deficiency, and hyperprolactinemia. The main objective of this case report is to present a case and to review the literature in relation to the neuroendocrine dysfunction associated to BTI. Case report. 33 years old male with severe brain trauma injury. Previously healthy. Who developed neuroendocrine dysfunction with central hyotiroidism (Low levels of T3 and TSH) hypogonadothropic hypogonadism (low levels of follicle stimulant hormone and luteinizing hormone, with low levels of testosterone, progesterone and estradiol) and hyperprolactinemia. The growth hormone and cortisol was normal. The patient developed diabetes insipidous that responded to DDAVP. We didn’t make any dynamic stimulation tests. Discussion. In this case report we describe the neuroendocrine dysfuntion during the patient stay in the ICU, who correlates with the reported in the literature. The patient required antidiuretic hormone substitution with arginine-vasopresine. The patient didn’t require any other hormonal replacement. Conclusion. The oportune and screening of the early diagnostic of neuroendocrine dysfunction is not only an endocrine curiosity, it also identifies the in-risk patient, and the need for hormonal replacement, to impact in the morbimortality and most important in the rehabilitation. This case report enfatizes the importance and frecuency of this entity and the need of more studies in our country.


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