Hypothalamo-hypofyzární dysfunkce a jejich hodnocení za různých patologických stavů.

Traumatic brain injury represents serious medical problem. Besides various types of complications, endocrine dysfunction of hypothalmo-pituitary units can occur. Aim of our work was to determine whether chronic subdural haematoma, as specific type of traumatic brain injury, is associated with a risk...

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Bibliographic Details
Main Author: Kosák, Mikuláš
Other Authors: Hána, Václav
Format: Doctoral Thesis
Language:Czech
Published: 2014
Online Access:http://www.nusl.cz/ntk/nusl-442215
Description
Summary:Traumatic brain injury represents serious medical problem. Besides various types of complications, endocrine dysfunction of hypothalmo-pituitary units can occur. Aim of our work was to determine whether chronic subdural haematoma, as specific type of traumatic brain injury, is associated with a risk of developing hypopituitarism as well. In a prospective study, pituitary functions in a cohort of 49 patients after surgery for chronic subdural haematoma, were evaluated. Patients were tested for hormonal deficits including dynamic tests, soon after surgery, in 3 and 12 months thereafter. 10 patients were tested retrospectively 12 months after surgery. Gonadotropic axis was impaired in 9 patients (25,7 %) in acute phase and reamained impaired in 3 (12 %) after 12 months. Growth hormone deficiency was present in 23 (46,9 %) patients during the acute phase and in 15 (46,9 %) patients in evaluation 12 months after the surgery. Serious hormonal deficiencies due to impairment of the most important axes (HPA a thyrotropic) were not proved in our patients. The second part of this work is devoted to the novel methods in diagnostic assesement of hypothalamo-pituitary-adrenocortical axis. Aim of our work was to evaluate and compare reliability of cortisol measurements in serum and saliva simultaneously during the...