Cardiovascular disease; Nervous system diseases; Pituitary diseases; Endocrinopathy; Subarachnoid hemorrhage; Bibliographic review; Head trauma; Review; Cause; Hypophyseal insufficiency; Pathologie de l'appareil circulatoire; Pathologie du système nerveux; Pathologie de l'hypophyse; Endocrinopathie; Hémorragie sousarachnoïdienne; Revue bibliographique; Traumatisme crânien; Article synthèse; Insuffisance hypophysaire
Abstract :
[en] Brain injuries namely traumatic brain injuries (TBI) and subarachnoid haemorrhage (SAH) are relevant causes of acquired adult hypopituitarism, perhaps more prevalent than ever believed. TBI represent a major health problem with an annual incidence of 300 cases per 100.000. SAH affects six new cases per 1.000.000 habitants in USA. In Belgium we estimate nearly 30.000 new TBI cases and 600 SAH cases per year. In the English literature, TBI secondary hypopituitarism has been well documented in 14 retrospective and prospective series accounting for 1.077 cases. In all these series the main pituitary deficits were: GH (14%), ACTH (14%), gonadotrope (18%), TSH (7%) and diabetes insipidus (4%). SAH was documented as a cause of hypopituitarism in three retrospective series accounting for 110 cases and in one prospective series. In all these series main pituitary deficits were GH (25%), ACTH (15%), gonadotrope (8.5%), TSH (6%) and diabetes insipidus (4%). In this review, we analyze recent data and discuss diagnostic and treatment features of secondary hypopituitarism due TBI and SAH. [fr] La prévalence de l'hypopituitarisme est largement sous-estimée et son étiologie est souvent méconnue. Le traumatisme crânien et l'hémorragie sous-arachnoïdienne constituent actuellement des causes importantes d'hypopituitarisme acquis de l'adulte. Les traumatismes crâniens représentent un problème majeur de santé publique, avec une incidence annuelle de 300 cas par 100.000 habitants, soit en Belgique 30.000 patients par an. L'hémorragie sous-arachnoïdienne représente quant à elle six cas par 100.000 habitants aux USA et on l'estime à 600 nouveaux cas par an en Belgique. Dans l'hypopituitarisme secondaire aux traumatismes crâniens, 14 séries rétrospectives et prospectives identifient chez 1.077 patients un déficit en GH ou somatotrope (14% des patients), un déficit en ACTH ou corticotrope (14%), un déficit en LH/FSH ou gonadotrope (18%), un déficit en TSH ou thyréotrope (7%) et un déficit en ADH ou diabète insipide (4%). Dans l'hémorragie sous-arachnoïdienne trois séries rétrospectives totalisant 110 patients rendent compte d'un déficit en GH (25%), en ACTH (15%), gonadotrope -LH/ FSH- (8,5 %), en TSH (6%) et d'un diabète insipide (4%); une seule étude prospective est disponible. Nous faisons le point sur ces données récentes et discutons du diagnostic et de la prise en charge de l'hypopituitarisme secondaire au traumatisme crânien et à l'hémorragie sous-arachnoïdienne.
Vroonen, Laurent ; Centre Hospitalier Universitaire de Liège - CHU > Endocrinologie clinique
Robe, Pierre ; Université de Liège - ULiège > Département des sciences biomédicales et précliniques > GIGA-R : Génétique générale et humaine - Département des sciences biomédicales et précliniques
Martin, Didier ; Centre Hospitalier Universitaire de Liège - CHU > Neurochirurgie
Beckers, Albert ; Université de Liège - ULiège > Département des sciences cliniques > Endocrinologie
Language :
French
Title :
Hypopituitarisme consécutif aux atteintes cérébrales: le traumatisme cranien et l'hémorragie sous-arachnoidienne mis en cause.
Alternative titles :
[en] Traumatic brain injury and subarachnoid hemorrhage as a cause of hypopituitarism: a review
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