Lionel R. King

Pituitary Hormone Response to Head Injury

Measurements of the serum levels of pituitary hormones were made in six patients with uncomplicated head injury. Samples were obtained at 4-hour intervals for 72 hours to evaluate diurnal rhythms. Three of the six patients revealed elevations of serum growth hormone (GH) and prolactin, but no trends could be established. Likewise, three patients had marked elevations of luteinizing hormone and lesser elevations of follicle-stimulating hormone, but no pattern was discernible. The level of thyroid-stimulating hormone was stable and remained in the normal range throughout. GH was measured after intravenous glucose loading. A paradoxical rise reverted to normal at the late follow-up evaluation. It is suggested that the abnormal levels were related to abnormal hypothalamic function rather than to pituitary damage.

EFFECTS OF HEAD INJURY ON METABOLISM AND OTHER ORGAN SYSTEMS

Injury to the brain cannot be treated as an isolated event but must be considered in its proper physiological setting. Since management of most head injuries is non-surgical, it follows that appropriate treatment consists mainly of establishing and supporting the optimum milieu to promote recovery of the damaged brain. It is essential, therefore, that the secondary effects of the injury on other organ and metabolic systems be recognized. The following discussion summarizes the present knowledge regarding such secondary effects and includes recommendations for recognition and treatment.