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Old 06-19-2018, 05:37 AM
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rss Central adrenal insufficiency following traumatic brain injury: a missed diagnosis in

Related Articles Central adrenal insufficiency following traumatic brain injury: a missed diagnosis in the critically injured.

Childs Nerv Syst. 2017 Dec;33(12):2205-2207

Authors: Fan E, Skippen PW, Sargent MA, Cochrane DD, Chanoine JP

Abstract
BACKGROUND: High-dose steroid administration is no longer recommended in the treatment of acute traumatic brain injury (TBI) as it failed to prove beneficial in improving patients' outcome. However, a masked benefit of steroid administration in TBI management was that it provided corticosteroid replacement therapy in patients with TBI-related central adrenal insufficiency.
CASE PRESENTATION: We report the case of a 12-year-old boy who suffered a severe TBI from a motor vehicle accident that resulted in complete deficiency of anterior pituitary function. Central adrenal insufficiency was not ruled out by a near normal response to a low-dose ACTH test performed on D11.
CONCLUSION: Consideration should be given to the empirical treatment of TBI pediatric patients with stress doses of corticosteroids if injury to the hypothalamus or pituitary gland is possible until a formal assessment of the hypothalamic-pituitary-adrenal axis can be made.


PMID: 28721596 [PubMed - indexed for MEDLINE]



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