133 results match your criteria Post Head Injury Endocrine Complications


Improving Voice Outcomes after Thyroid Surgery and Ultrasound-Guided Ablation Procedures.

Front Surg 2022 4;9:882594. Epub 2022 May 4.

Sarasota Memorial Health Care System Multidisciplinary Thyroid and Parathyroid Center, Sarasota, Florida, United States.

The field of endocrine surgery has expanded from the traditional open neck approach to include remote access techniques as well as minimally invasive approaches for benign and malignant thyroid nodules. In experienced hands and with careful patient selection, each approach is considered safe, however complications can and do exist. Post-operative dysphonia can have serious consequences to the patient by affecting quality of life and ability to function at work and in daily life. Read More

View Article and Full-Text PDF

Association of Traumatic Brain Injury With the Risk of Developing Chronic Cardiovascular, Endocrine, Neurological, and Psychiatric Disorders.

JAMA Netw Open 2022 04 1;5(4):e229478. Epub 2022 Apr 1.

Harvard Medical School, Boston, Massachusetts.

Importance: Increased risk of neurological and psychiatric conditions after traumatic brain injury (TBI) is well-defined. However, cardiovascular and endocrine comorbidity risk after TBI in individuals without these comorbidities and associations with post-TBI mortality have received little attention.

Objective: To assess the incidence of cardiovascular, endocrine, neurological, and psychiatric comorbidities in patients with mild TBI (mTBI) or moderate to severe TBI (msTBI) and analyze associations between post-TBI comorbidities and mortality. Read More

View Article and Full-Text PDF

Diagnosis and surgical repair of delayed tracheal perforation post thyroidectomy in context of previous cranio-spinal radiotherapy - A case report.

Int J Surg Case Rep 2022 Feb 10;91:106761. Epub 2022 Jan 10.

General and Endocrine Surgery, Department of General Surgery, Rockingham General Hospital, Elanora Drive, Cooloongup, Western Australia 6168, Australia. Electronic address:

Introduction And Importance: This is the first case of delayed tracheal perforation post total thyroidectomy in the context of previous radiotherapy to the neck. Such a presentation can be easily misdiagnosed and managed as a seroma at significant risk to the patient, as the latter had no precipitating factors and cardiorespiratory compromise. There are nineteen previously described cases of delayed tracheal injury post thyroidectomy of variable severity and variable intervention. Read More

View Article and Full-Text PDF
February 2022

Routine Exposure Versus Non-Exposure of Recurrent Laryngeal Nerve during Thyroid Surgery: Our Experience of 300 Cases.

Mymensingh Med J 2022 Jan;31(1):154-160

Dr Sudhangshu Shekhar Biswas, Associate Professor, ENT and Head Neck Surgery Department, BIRDEM General Hospital & Ibrahim Medical College (IMC), Dhaka, Bangladesh; E-mail:

The technique of thyroidectomy has been in evolution for many years. It is a basic rule of surgery that an important structure of a human body must be recognized certainly during the surgical procedure in order to prevent its damage. The purpose of this study was to evaluate our routine identification and without identification of recurrent laryngeal nerve during thyroidectomy aiming to lessen the inadvertent injury of the recurrent laryngeal nerve. Read More

View Article and Full-Text PDF
January 2022

Improving Voice Outcomes After Thyroid Surgery - Review of Safety Parameters for Using Energy-Based Devices Near the Recurrent Laryngeal Nerve.

Front Endocrinol (Lausanne) 2021 24;12:793431. Epub 2021 Nov 24.

Department of Otorhinolaryngology-Head and Neck Surgery, International Thyroid Surgery Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.

Technological advances in thyroid surgery have rapidly increased in recent decades. Specifically, recently developed energy-based devices (EBDs) enable simultaneous dissection and sealing tissue. EBDs have many advantages in thyroid surgery, such as reduced blood loss, lower rate of post-operative hypocalcemia, and shorter operation time. Read More

View Article and Full-Text PDF
February 2022

One hundred and one consecutive transoral endoscopic parathyroidectomies via the vestibular approach for PHPTH: a worldwide multi-institutional experience.

Surg Endosc 2022 Jul 5;36(7):4821-4827. Epub 2021 Nov 5.

Division of Head and Neck Endocrine Surgery, Department of Otolaryngology Head and Neck Surgery, Johns Hopkins University, 601 N. Caroline 6th Floor, Baltimore, MD, 21287, USA.

Importance: The transoral vestibular approach for thyroid and parathyroid surgery is being adopted rapidly world-wide. Currently there is a paucity of information on this approach for primary hyperparathyroidism (PHPTH). If this approach is safe and efficacious it would provide patients a completely scarless option for parathyroidectomy. Read More

View Article and Full-Text PDF

Thyroid function in the subacute phase of traumatic brain injury: a potential predictor of post-traumatic neurological and functional outcomes.

J Endocrinol Invest 2022 Feb 5;45(2):379-389. Epub 2021 Aug 5.

Neurorehabilitation and Spinal Unit, Istituti Clinici Scientifici Maugeri SPA SB, Institute of Pavia, IRCCS, Pavia, Italy.

Purpose: That thyroid hormones exert pleiotropic effects and have a contributory role in triggering seizures in patients with traumatic brain injury (TBI) can be hypothesized. We aimed at investigating thyroid function tests as prognostic factors of the development of seizures and of functional outcome in TBI.

Methods: This retrospective study enrolled 243 adult patients with a diagnosis of mild-to-severe TBI, consecutively admitted to our rehabilitation unit for a 6-month neurorehabilitation program. Read More

View Article and Full-Text PDF
February 2022

Diaphragma sellae sinking can predict the onset of hyponatremia after transsphenoidal surgery for pituitary adenomas.

J Endocrinol Invest 2021 Nov 14;44(11):2511-2520. Epub 2021 Jun 14.

Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, 350025, China.

Purpose: Sinking of the diaphragma sellae (DS) may stretch the pituitary stalk, which in turn impairs neurohypophyseal function; thus, it may play a role in the development of postoperative hyponatremia. We aimed to assess the factors influencing the development of hyponatremia after transsphenoidal surgery (TSS) for pituitary adenomas and analyze the effect of DS sinking on hyponatremia.

Methods: After applying the inclusion and exclusion criteria, we retrospectively analyzed the clinical data of patients with pituitary adenoma who underwent TSS. Read More

View Article and Full-Text PDF
November 2021

[Hypopituitarism after traumatic brain injury].

Rev Med Chil 2020 Dec;148(12):1796-1805

Departamento de Endocrinología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.

Hypopituitarism after moderate or severe traumatic brain injury (TBI) is usually underdiagnosed and therefore undertreated. Its course can be divided in an acute phase during the first 14 days after TBI with 50 to 80% risk of hypopituitarism, and a chronic phase, beginning three months after the event, with a prevalence of hypopituitarism that ranges from 2 to 70%. Its pathophysiology has been addressed in several studies, suggesting that a vascular injury to the pituitary tissue is the most important mechanism during the acute phase, and an autoimmune one during chronic stages. Read More

View Article and Full-Text PDF
December 2020

Traumatic Brain Injury as Frequent Cause of Hypopituitarism and Growth Hormone Deficiency: Epidemiology, Diagnosis, and Treatment.

Front Endocrinol (Lausanne) 2021 15;12:634415. Epub 2021 Mar 15.

Division of Endocrinology, Diabetes and Metabolism, University of Turin, Turin, Italy.

Traumatic brain injury (TBI)-related hypopituitarism has been recognized as a clinical entity for more than a century, with the first case being reported in 1918. However, during the 20 century hypopituitarism was considered only a rare sequela of TBI. Since 2000 several studies strongly suggest that TBI-mediated pituitary hormones deficiency may be more frequent than previously thought. Read More

View Article and Full-Text PDF
December 2021

Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition).

Autophagy 2021 Jan 8;17(1):1-382. Epub 2021 Feb 8.

University of Crete, School of Medicine, Laboratory of Clinical Microbiology and Microbial Pathogenesis, Voutes, Heraklion, Crete, Greece; Foundation for Research and Technology, Institute of Molecular Biology and Biotechnology (IMBB), Heraklion, Crete, Greece.

In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Read More

View Article and Full-Text PDF
January 2021

Energy Based Vessel Sealing Devices in Thyroid Surgery: A Systematic Review to Clarify the Relationship with Recurrent Laryngeal Nerve Injuries.

Medicina (Kaunas) 2020 Nov 27;56(12). Epub 2020 Nov 27.

Department of Medical and Surgical Sciences, University of Foggia, Luigi Pinto Street, No. 1, 71122 Foggia, Italy.

The principal complications associated with thyroid surgery consist in postoperative recurrent laryngeal nerve (RLN) palsy, hypoparathyroidism, intra-operative and post-operative hemorrhage. In this paper, structured as a literature review, we describe the current knowledge and the technical improvements currently employed in the field of thyroid surgery, focusing on the contribution of energy based devices in relation with the reduction of the operating time and the odds of possible complication. a relevant systematic literature search on Pubmed was carried out including works from 2004 through 2019, selecting studies providing information on the energy based devices employed in surgeries and statistic data concerning RNL (transient and permanent) injury and operative time. Read More

View Article and Full-Text PDF
November 2020

Investigation of recurrent laryngeal palsy rates for potential associations during thyroidectomy.

ANZ J Surg 2020 09 11;90(9):1733-1737. Epub 2020 Aug 11.

Monash University Endocrine Surgery Unit, The Alfred Hospital, Melbourne, Victoria, Australia.

Background: There are many clinical associations and potential mechanisms of injury resulting in recurrent laryngeal nerve palsy (RLNP) after thyroidectomy. One possible cause of RLNP is focal intralaryngeal compression of the recurrent laryngeal nerve (RLN), which may be associated with the tracheal tube (TT). Therefore, we examined current RLNP rates to investigate potential associations, including intralaryngeal, airway, anaesthetic and anthropometric factors. Read More

View Article and Full-Text PDF
September 2020

Diagnosis and treatment of low T3 syndrome in neurocritical patients.

J Clin Pharm Ther 2020 Aug 14;45(4):759-766. Epub 2020 May 14.

Department of Neurosurgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.

What Is Known And Objective: Low levels of serum triiodothyronine (T3) are a strong predictor of mortality and poor prognosis in critical care patients. Few reports, however, have focused on neurocritical patients. The application of hormone replacement therapy (HRT) in the treatment of neurocritical patients with low T3 syndrome remains controversial. Read More

View Article and Full-Text PDF

Long-term neuroendocrine consequences of traumatic brain injury and strategies for management.

Expert Rev Endocrinol Metab 2020 03 5;15(2):123-139. Epub 2020 Mar 5.

Department of Endocrinology and Metabolism, Memorial Kayseri Hospital, Kayseri, Turkey.

: Traumatic brain injuries (TBI) are reported to cause neuroendocrine impairment with a prevalence of 15% with confirmatory testing. Pituitary dysfunction (PD) may have detrimental effects on vital parameters as well as on body composition, cardiovascular functions, cognition, and quality of life. Therefore, much effort has been made to identify predictive factors for post-TBI PD and various screening strategies have been offered. Read More

View Article and Full-Text PDF

Anti-Pituitary and Anti-Hypothalamus Autoantibody Associations with Inflammation and Persistent Hypogonadotropic Hypogonadism in Men with Traumatic Brain Injury.

J Neurotrauma 2020 07 13;37(14):1609-1626. Epub 2020 Apr 13.

Department of Physical Medicine & Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

Traumatic brain injury (TBI) and can lead to persistent hypogonadotropic hypogonadism (PHH) and poor outcomes. We hypothesized that autoimmune and inflammatory mechanisms contribute to PHH pathogenesis. Men with moderate-to-severe TBI ( = 143) were compared with healthy men ( = 39). Read More

View Article and Full-Text PDF

Biochemical Mechanisms and Translational Relevance of Hippocampal Vulnerability to Distant Focal Brain Injury: The Price of Stress Response.

Authors:
N V Gulyaeva

Biochemistry (Mosc) 2019 Nov;84(11):1306-1328

Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, Moscow, 117485, Russia.

Focal brain injuries (in particular, stroke and traumatic brain injury) induce with high probability the development of delayed (months, years) cognitive and depressive disturbances which are frequently comorbid. The association of these complications with hippocampal alterations (in spite of the lack of a primary injury of this structure), as well as the lack of a clear dependence between the probability of depression and dementia development and primary damage severity and localization served as the basis for a new hypothesis on the distant hippocampal damage as a key link in the pathogenesis of cognitive and psychiatric disturbances. According to this hypothesis, the excess of corticosteroids secreted after a focal brain damage, in particular in patients with abnormal stress-response due to hypothalamic-pituitary-adrenal axis (HPAA) dysfunction, interacts with corticosteroid receptors in the hippocampus inducing signaling pathways which stimulate neuroinflammation and subsequent events including disturbances in neurogenesis and hippocampal neurodegeneration. Read More

View Article and Full-Text PDF
November 2019

Lifelong consequences of brain injuries during development: From risk to resilience.

Front Neuroendocrinol 2019 10 24;55:100793. Epub 2019 Sep 24.

Department of Neuroscience, Group in Behavioral Neuroendocrinology, Center for Brain and Spinal Cord Repair, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA.

Traumatic brain injuries in children represent a major public health issue and even relatively mild injuries can have lifelong consequences. However, the outcomes from these injuries are highly heterogeneous, with most individuals recovering fully, but a substantial subset experiencing prolonged or permanent disabilities across a number of domains. Moreover, brain injuries predispose individuals to other kinds of neuropsychiatric and somatic illnesses. Read More

View Article and Full-Text PDF
October 2019

Activation of pituitary axis according to underlying critical illness and its effect on outcome.

J Crit Care 2019 12 6;54:22-29. Epub 2019 Jul 6.

Anestesiologia e Rianimazione, Dipartimento di Scienze e Biotecnologie Medico Chirurgiche, Università di Roma La Sapienza, Roma, Italy. Electronic address:

Purpose: Critical illness is a life threatening condition inducing a severe acute physical stress. The aim of the study was to investigate the activation of pituitary axis early after ICU admission in patients with critical illnesses of different etiology and its association with outcome.

Materials And Methods: Patients admitted for acute respiratory distress syndrome (ARDS), severe traumatic brain injury (TBI), subarachnoid hemorrhage (SAH) and neurocritically ill patients at the moment of brain death (BD) diagnosis were included in the present post-hoc analysis. Read More

View Article and Full-Text PDF
December 2019

Effect of surgeons' annual operative volume on the risk of permanent Hypoparathyroidism, recurrent laryngeal nerve palsy and Haematoma following thyroidectomy: analysis of United Kingdom registry of endocrine and thyroid surgery (UKRETS).

Langenbecks Arch Surg 2019 Jun 28;404(4):421-430. Epub 2019 Jun 28.

Consultant Endocrine Surgeon, Nottingham University Hospitals NHS Trust, City Campus, Nottingham, UK.

Purpose: Categorize data to investigate the surgeon volume outcome relationship in thyroidectomies. Determine the evidence base for recommending a minimum number of thyroidectomies performed per year to maintain surgical competency.

Methods: Data on thyroid operations in the United Kingdom Registry of Endocrine and Thyroid Surgery (UKRETS) from 01/09/2010 to 31/08/2016 was analysed. Read More

View Article and Full-Text PDF

Prevalence of Anterior Pituitary Dysfunction Twelve Months or More following Traumatic Brain Injury in Adults: A Systematic Review and Meta-Analysis.

J Neurotrauma 2020 01 21;37(2):217-226. Epub 2019 Oct 21.

Center for Clinical Brain Sciences, University of Edinburgh and NHS Lothian Western General Hospital, Edinburgh, United Kingdom.

The objective of this study is to systematically review clinical studies that have reported on the prevalence of chronic post-traumatic brain injury anterior pituitary dysfunction (PTPD) 12 months or more following traumatic brain injury (TBI). We searched Medline, Embase, and PubMed up to April 2017 and consulted bibliographies of narrative reviews. We included cohort, case-control, and cross-sectional studies enrolling at least five adults with primary TBI in whom at least one anterior pituitary axis was assessed at least 12 months following TBI. Read More

View Article and Full-Text PDF
January 2020

May predictors of difficulty in thyroid surgery increase the incidence of complications? Prospective study with the proposal of a preoperative score.

BMC Surg 2019 Apr 24;18(Suppl 1):116. Epub 2019 Apr 24.

Department of General Microsurgery and Hand Surgery, "Fabia Mater" Hospital, Rome, Italy.

Background: Although thyroidectomy is one of the most common surgical procedures performed worldwide, some permanent complications, despite the considerably reducing incidence, may affect dramatically the patients quality of life. The purpose of this study is to evaluate whether factors identified preoperatively and expressed in a score could be predictors of major surgical difficulty during total thyroidectomy and influence the incidence of complications.

Methods: A total of 164 patients who underwent total thyroidectomy were examined. Read More

View Article and Full-Text PDF

Postoperative Complications of Transsphenoidal Pituitary Adenectomy: A Single Institution Based Experience.

Kathmandu Univ Med J (KUMJ) 2019 Apr-Jun;17(66):123-125

Department of Neurosurgery, Upendra Devkota Memorial National Institute of Neurological and Allied Sciences, Bansbari, Kathmandu, Nepal.

Background Inside a cranium, pituitary gland seats in an area of complex anatomical construct. Further it holds a very important physiological role to maintain all bodily function. Pituitary adenoma being one of the commonest tumors of that intricate area is preferably tackled with transsphenoidal approach. Read More

View Article and Full-Text PDF

Pituitary pathology in traumatic brain injury: a review.

Pituitary 2019 Jun;22(3):201-211

Department of Laboratory Medicine, Division of Pathology, St Michael's Hospital, University of Toronto, Toronto, ON, Canada.

Purpose: Traumatic brain injury most commonly affects young adults under the age of 35 and frequently results in reduced quality of life, disability, and death. In long-term survivors, hypopituitarism is a common complication.

Results: Pituitary dysfunction occurs in approximately 20-40% of patients diagnosed with moderate and severe traumatic brain injury giving rise to growth hormone deficiency, hypogonadism, hypothyroidism, hypocortisolism, and central diabetes insipidus. Read More

View Article and Full-Text PDF

Pituitary deficiency and precocious puberty after childhood severe traumatic brain injury: a long-term follow-up prospective study.

Eur J Endocrinol 2019 May;180(5):281-290

Paediatric Endocrinology, Gynaecology and Diabetology Unit, Assistance Publique-Hôpitaux de Paris, Necker Enfants-Malades University Hospital, Paris, France.

Objectives Childhood traumatic brain injury (TBI) is a public health issue. Our objectives were to determine the prevalence of permanent pituitary hormone deficiency and to detect the emergence of other pituitary dysfunctions or central precocious puberty several years after severe TBI. Design Follow-up at least 5 years post severe TBI of a prospective longitudinal study. Read More

View Article and Full-Text PDF

The frequency and the diagnosis of pituitary dysfunction after traumatic brain injury.

Pituitary 2019 Jun;22(3):249-260

Academic Department of Endocrinology, Beaumont Hospital and the RCSI Medical School, Beaumont Road, Dublin 9, Ireland.

Purpose: Clinical research studies over the last 15 years have reported a significant burden of hypopituitarism in survivors of traumatic brain injury (TBI). However, debate still exists about the true prevalence of hypopituitarism after head injury.

Methods: We have reviewed the literature describing the frequency of post-traumatic hypopituitarism and discuss the factors which may explain the variable frequency of the reported deficits in clinical studies including research methodology and the natural history of the disease. Read More

View Article and Full-Text PDF

Intraoperative neuromonitoring versus visual nerve identification for prevention of recurrent laryngeal nerve injury in adults undergoing thyroid surgery.

Cochrane Database Syst Rev 2019 Jan 19;1:CD012483. Epub 2019 Jan 19.

Department of General Surgery, University of Perugia, Terni, Italy, 05100.

Background: Injuries to the recurrent inferior laryngeal nerve (RILN) remain one of the major post-operative complications after thyroid and parathyroid surgery. Damage to this nerve can result in a temporary or permanent palsy, which is associated with vocal cord paresis or paralysis. Visual identification of the RILN is a common procedure to prevent nerve injury during thyroid and parathyroid surgery. Read More

View Article and Full-Text PDF
January 2019

Hypoxic stress: A risk factor for post-concussive hypopituitarism?

Med Hypotheses 2018 Dec 6;121:31-34. Epub 2018 Sep 6.

Vienna Chiropractic Associates, P.C. (Private Practice of Chiropractic), 243 Church Street NW, #300-B, Vienna, VA 22180, USA. Electronic address:

Hypopituitarism diagnosed months or years following concussive injury can cause a variety of endocrine disturbances including insufficient secretion of human growth, luteinizing, follicle stimulating, thyroid stimulating, adrenocorticotrophic, and antidiuretic hormones. Recent evidence suggests that autoimmune reactions against pituitary and/or hypothalamic tissue constitute an etiologic factor for this hypopituitarism. One important trigger for autoimmunity is hypoxic stress. Read More

View Article and Full-Text PDF
December 2018

The interplay between neuroendocrine and sleep alterations following traumatic brain injury.

NeuroRehabilitation 2018 ;43(3):327-345

Centre for Neuro Skills, Encino, CA, USA.

Background: Sleep and endocrine disruptions are prevalent after traumatic brain injury (TBI) and are likely to contribute to morbidity.

Objective: To describe the interaction between sleep and hormonal regulation following TBI and elucidate the impact that alterations of these systems have on cognitive responses during the posttraumatic chronic period.

Methods: Review of preclinical and clinical literature describing long-lasting endocrine dysregulation and sleep alterations following TBI. Read More

View Article and Full-Text PDF
January 2019

Posterior pituitary dysfunction following traumatic brain injury: review.

Pituitary 2019 Jun;22(3):296-304

Academic Department of Endocrinology, Beaumont Hospital/RCSI Medical School, Dublin, Ireland.

Neurohypophysial dysfunction is common in the first days following traumatic brain injury (TBI), manifesting as dysnatremia in approximately 1 in 4 patients. Both hyponatremia and hypernatremia can impair recovery from TBI and in the case of hypernatremia, there is a significant association with excess mortality. Hyponatremia secondary to syndrome of inappropriate antidiuretic hormone secretion (SIAD) is the commonest electrolyte disturbance following TBI. Read More

View Article and Full-Text PDF