Study links brain injury to pituitary dysfunction

BRAIN TRAUMA from a head injury or stroke can be linked with pituitary problems in some patients, according to research at Beaumont Hospital.

Awareness of that link could help address hormone-related problems faced by some patients following brain injuries, according to Beaumont consultant endocrinologist, Prof Chris Thompson.

"The endocrine system is a series of glands throughout the body which modulates much of the body’s metabolic activities, and they are all under the control of the pituitary gland," he explained. "So if there is dysfunction of the pituitary gland, those glands can't function correctly."

The Beaumont study was inspired by observations that some patients had developed an under-active pituitary as a result of brain injury.

"One young man in particular had his life severely compromised by pituitary disease, but when we were able to diagnose this and to treat it correctly he had a return to a fantastically productive life," said Prof Thompson.

The prospective studies at Beaumont involved about 200 patients with severe head injuries - mostly from traffic accidents or falls - or a type of stroke called a sub-arachnoid haemorrhage, explained Prof Thompson, who is professor of endocrinology at the Royal College of Surgeons in Ireland.

The findings showed that levels of stress hormones could be affected in the acute time after a stroke, he said.

"Because the pituitary was being stunned or transiently harmed, it wasn't directing the adrenal gland to produce cortisol, cortisol levels were falling and the normal stress response, which helps people to survive injuries like sub-arachnoid haemorrhage."

Overall, about 30 per cent of long-term survivors of traumatic brain injury showed evidence of pituitary dysfunction, noted Prof Thompson, and he described how that could lead to symptoms such as fatigue, headache, menstrual irregularity and erectile dysfunction.

"The important thing is to be aware of the problem," he said. "So if someone had symptoms that might be related to that you recognise it and you can treat accordingly."

Prof Thompson also highlighted the need for recognition and funding for a national dedicated pituitary treatment unit. "Although the Beaumont and Cork units provide the bulk of multidisciplinary care for pituitary patients in Ireland, there is no official recognition or funding of these two units as providers of pituitary care," he said. "This leaves them vulnerable to bed closures and interruption of delivery of care."

Pituitary Awareness Week run by the Irish branch of the Pituitary Foundation ends on October 8th