Hipopituitarismo post traumatismo craneoencefálico moderado y severo: revisión bibliográfica y propuesta de algoritmo diagnóstico.

Abstract

Introduction: Traumatic brain injury (TBI) is a condition of great importance in public health, which presents neuroendocrine complications, such as post-TBI hypopituitarism (HPTCE), which is usually underdiagnosed and therefore undertreated. A unified algorithm is proposed for the diagnosis of HPTCE, improving effective care and quality of life for those affected by this condition. Objective: Establish the existence of diagnostic strategies for moderate and severe HPTCE and propose a unified diagnostic algorithm. Methods: Review of the literature published in the last seven years in Spanish and English. Articles found in Google Scholar, SciELO and PUBMED were used, applying the PRISMA method. Results: The initial search identified 1056 publications. After removing duplicates and irrelevant articles, 37 full articles were reviewed, excluding 21 for not meeting the criteria. Three articles were added by citation, ultimately resulting in 19 studies that met the inclusion criteria. Conclusion: The frequency of hypopituitarism is higher in moderate and severe TBI and is associated with risk factors such as admission to the ICU, patient screening should be done in all patients, in whom it is recommended to perform hormonal tests from 3 months later of trauma.