الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
This study included 50 patients with traumatic brain injury (37 men and 13 women) with an age ranging from 18 to 65 years (mean ±SD 37.5611.6). The patients were recruited from neurosurgery department, Emergency hospital, Mansoura university between September 2007 and September 2009. Aim of the work The aim of this work is clarifying the impact of traumatic brain injury on anterior pituitary function in the acute phase & follow up period, as well as assessment the risk factors and predictors of pituitary dysfunction following traumatic brain injury and whether initial hormone correlated with post recovery hormonal status. Results • In this study GCS were significantly lower in patient with severe TBI compared with those with moderate TBI. Non significant difference in age, male to female ratio, creatinine, ALT , PT and waist circumference were also found. • In this study total testosterone and LH levels was significantly lower and higher PRL level in patient with severe TBI compared with those of moderate TBI in the acute phase. No significant difference in mean, fT3, fT4, TSH, cortisol , FSH, and basal GH levels among the subjects with moderate and severe TBI. • As regard the prevalence of pituitary hormones deficiencies in the acute phase the present study demonstrated that GH deficiency was 13 of 50 patients ( 26 %), hyperprolactinemia was observed in 23 of 50 patients ( 46 %), central hypothyroidism was detected in 4 of 50 patients ( 8 %), basal cortisol deficiency was found among 4 of 50 patients ( 8 %) , male hypogonadism was detected among 19 of 37 male patients ( 51.3 %) while hypopituitarism was present in 31 of 50 patients (62 %). • In this study, in the acute phase GHD patients had significantly longer waist circumference and older age in comparison to GH-sufficient patients and GHD patients. • In this study sex not affect pituitary hormones level in acute phase. No significant difference in mean fT3, fT4, TSH, cortisol, FSH, LH, prolactin and provocative GH levels among male subjects in comparison to Female subjects, • In this study testosterone-deficient males had significantly lower GSC and older age in comparison to testosterone–sufficient male patients, Also testosterone-deficient male had significantly higher PRL and lower LH mean in comparison to testosterone–sufficient male patients. • In this study cortisol-deficient patient had non significant hormonal nor other parameter in comparison to cortisol-sufficient patients. • In this study when mean hormones levels in the acute phase and 3 months after TBI were compared, there were no significant difference in mean of fT4, GH and FSH levels. However, there was a significant increase in mean of TSH, fT3, LH and total testosterone levels and a significant decrease in PRL and cortisol levels 3 months after TBI. • In this study, there was a significant negative correlation between PRL level and GSC mean. Also there was a significant positive correlation between LH and total testosterone levels and GSC mean. Summary and Conclusion From this study, it is concluded that hormonal changes in the very early phase after TBI were prevalent, and we recommend screening of pituitary hormone in the acute phase and in follow up period although pituitary hormone deficiency in the acute phase did not generally predict the hormone deficiencies. Taken together, 31 0f 50 patients (62 %) had at least one anterior pituitary hormone deficiency. Therefore, screening of pituitary function is crucial after severe or, moderate in acute phase and for follow up for pituitary dysfunction.