Moderate to Severe Traumatic Brain Injury Clinical Trial
Official title:
Are Ante-hypophyseal Dysfunctions in the Acute Phase of Moderate to Severe Traumatic Brain Injury Predictive of Long-term Ante-hypophyseal Sequelae in Children?
Annual incidence of severe traumatic brain injuries (TBI) varies from 180 to 300 out of
100.000. Mortality or severe sequelae risk is increased 8 fold after a TBI. Studies in adults
showed an ante-hypophyseal deficit in 28 to 68 % of patients with a TBI. The most common
deficit is Growth Hormone Deficit (GHD); followed by gonadotropic and corticotropic
(AdrenoCorticoTropic Hormone (ACTH)) insufficiencies. Thyrotropic deficits
(Thyroid-Stimulating Hormone (TSH)) are less frequent. From a pathophysiological point of
view, the lesional mechanism responsible for hypopituitarisms would be a damage of
hypophyseal vessels or hypothalamic-pituitary vessels. The frequency of pituitary deficits
and the potential beneficial effects of replacement therapy on quality of life, tiredness,
loss of energy and productivity, justify the systematic detection of the deficits in patients
with moderate to severe TBI.
Study hypotheses :
At the present time, the lack of data in children does not give us the opportunity to affirm
that one part of the symptoms showed by children with post-TBI neuropsychological sequelae,
are linked to pituitary deficiency and that they can be improved with a replacement therapy.
Firstly, it is essential to better understand the natural history of post-TBI pituitary
deficiencies, studying the connexion between observed deficiencies in acute and late phase of
sequelae.
n/a
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N/A | |
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