Central adrenal insufficiency following traumatic brain injury: a missed diagnosis in the critically injured.
Childs Nerv Syst
; 33(12): 2205-2207, 2017 Dec.
Article
em En
| MEDLINE
| ID: mdl-28721596
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.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Estado Terminal
/
Insuficiência Adrenal
/
Erros de Diagnóstico
/
Lesões Encefálicas Traumáticas
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
Limite:
Child
/
Humans
/
Male
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article