{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T01:36:46Z","timestamp":1783820206614,"version":"3.55.0"},"reference-count":36,"publisher":"SAGE Publications","issue":"22","license":[{"start":{"date-parts":[[2015,11,1]],"date-time":"2015-11-01T00:00:00Z","timestamp":1446336000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2015,11]]},"abstract":"<jats:p>Hypopituitarism may often occur in association with traumatic brain injury (TBI). Identification of reliable predictors of pituitary dysfunction is of importance in order to establish a rational testing approach.<\/jats:p>\n                  <jats:p>We searched the records of patients with TBI, who underwent neuroendocrine evaluation in our institution between 2007 and 2013.<\/jats:p>\n                  <jats:p>\n                    One hundred sixty-six adults (70% men) with TBI (median age: 41.6 years; range: 18\u201376) were evaluated at a median interval of 40.4 months (0.2\u2013430.4).Of these, 31% had \u22651 pituitary deficiency, including 29% of patients with mild TBI and 35% with moderate\/severe TBI. Growth hormone deficiency was the most common deficiency (21%); when body mass index (BMI)-dependent cutpoints were used, this was reduced to 15%. Central hypoadrenalism occurred in10%, who were more likely to have suffered a motor vehicle accident (MVA,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.04), experienced post-traumatic seizures (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.04), demonstrated any intracranial hemorrhage (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.05), petechial brain hemorrhages (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.017), or focal cortical parenchymal contusions (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.02). Central hypothyroidism occurred in 8% and central hypogonadism in 12%; the latter subgroup had higher BMI (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.03), were less likely to be working after TBI (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.002), and had lower Global Assessment of Functioning (GAF) scores (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.03). Central diabetes insipidus (DI) occurred in 6%, who were more likely to have experienced MVA (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001) or sustained moderate\/severe TBI (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001).\n                  <\/jats:p>\n                  <jats:p>Patients with MVA and those with post-traumatic seizures, intracranial hemorrhage, petechial brain hemorrhages, and\/or focal cortical contusions are at particular risk for serious pituitary dysfunction, including adrenal insufficiency and DI, and should be referred for neuroendocrine testing. However, a substantial proportion of patients without these risk factors also developed hypopituitarism.<\/jats:p>","DOI":"10.1089\/neu.2015.3998","type":"journal-article","created":{"date-parts":[[2015,9,28]],"date-time":"2015-09-28T10:31:25Z","timestamp":1443436285000},"page":"1789-1795","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":54,"title":["Predictors of Hypopituitarism in Patients with Traumatic Brain Injury"],"prefix":"10.1177","volume":"32","author":[{"given":"Paula P.B.","family":"Silva","sequence":"first","affiliation":[{"name":"Massachusetts General Hospital and Harvard Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saurabha","family":"Bhatnagar","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital and Harvard Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seth D.","family":"Herman","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital and Harvard Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross","family":"Zafonte","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital and Harvard Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Klibanski","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital and Harvard Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen K.","family":"Miller","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital and Harvard Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas A.","family":"Tritos","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital and Harvard Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2015,11,15]]},"reference":[{"key":"e_1_3_2_2_2","unstructured":"Centers for Disease Control and Prevention NCfIPaC Division of Unintentional Injury Prevention. 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