Evaluation of TSH and ACTH Hormone Levels During the Acute Phase after Traumatic Brain Injury in Pediatric Cases

Objective: Head trauma is a clinical condition including a number of conditions, ranging from scalp injury to severe brain damage. In various adult studies, it was shown that pituitary dysfunction may develop in the acute phase after traumatic brain injury (TBI). However, in pediatric cases, there are few studies on this issue. This study aims to examine the effects of acute TBI on the HPA axis and thyroid axis during the pediatric period. Materials and Methods: The study includes 30 TBI cases admitted to the Neurosurgery Intensive Care Unit. Trauma severity was measured by GCS. In the first 24 hours, blood samples were taken to measure basal hormone levels (TSH, T3, T4, ACTH and Cortisol). Results: In 7 (23.3%) out of 30 cases ACTH deficiency; in 4 (13.3%) cases TSH deficiency and in 11 cases (36.6%) euthyroid- sick syndrome was found. There was no correlation between the trauma severity and hormonal deficiency, but a positive correlation was present between ACTH and Cortisol. Conclusion: This study showed that, in children admitted due to head trauma, pituitary hormonal dysfunction might develop in the acute phase after TBI. Early diagnosis of the existence of such critical conditions, particularly adrenal deficiency, may be life-saving.