High frequency of empty sella, with gender differences, in the early neuroradiology evaluation of patients with traumatic brain injury. A prospective study.
J Clin Transl Endocrinol
; 15: 54-61, 2019 Mar.
Article
em En
| MEDLINE
| ID: mdl-30622899
ABSTRACT
One-hundred four persons agedâ¯≥â¯18â¯years (62 males and 42 females) who were admitted for traumatic brain injury (TBI) underwent brain computed tomography (CT) scan and assay of serum cortisol, insulin-like growth factor 1 (IGF-1), thyrotropin (TSH) and free thyroxine (FT4). The main purpose was to assess any gender difference and the rate of empty sella (ES). Women were more likely to have empty sella (19/42 [45.2%] vs 19/62 [30.6%], Pâ¯=â¯0.15, ORâ¯=â¯1.9), which was more frequently total ES or TES (16/19 [84.2%] vs 3/19 [15.8%], Pâ¯=â¯0.0025, ORâ¯=â¯11.6). Neuroradiology was normal in the remaining 65 patients. Patients with TES were approximately 20-30â¯years older than both patients with partial ES (PES) and normal sella, but only the comparison with normal sella was significant (Pâ¯=â¯0.001 all patients, Pâ¯=â¯0.005 males). Presumed deficiency of IGF-1, cortisol or TSH occurred in 33 persons (31.7%; 20 Males [32.2%], 13 Females [30.9%]), 14 (13.5%; 10â¯M [16.2%], 4F [9.5%]) or 8 (7.7%; 1â¯M [1.7%], 7F [16.7%]), with only TSH deficiency having significant intergender difference (Pâ¯=â¯0.007). The highest or lowest rates of IGF-1 deficiency occurred in men with PES (41.7%) or men with TES (14.3%), of cortisol deficiency in men with PES (33.3%) or women with PES (zero), and TSH deficiency in women with TES (18.7%) or both men and women with PES (zero) and men with normal sella (zero). Within ES, males with no deficiency were older compared to males with at least one hormone deficiency (75.7⯱â¯17.4 vs 55.6⯱â¯18.9, Pâ¯=â¯0.022); in turn, the former males were also older compared with normal sella males having no hormone deficiency (54.1⯱â¯25.2, Pâ¯=â¯0.023). In conclusion, ES is detectable in almost 40% of persons who undergo CT within 24â¯h from TBI. A number of intergender differences concerning ES and the hormones evaluated are apparent.
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Base de dados:
MEDLINE
Tipo de estudo:
Observational_studies
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article