Sequelae of head injuries

The long-term complications of head injury are:

• hemisphere syndromes - hemiplegia, aphasia - dominant hemisphere, spatial neglect - non-dominant hemisphere, visual field defects; rarely, dystonia, due to damage to the deep basal ganglia
• brainstem syndromes - limb tremor, unsteadiness of gait
• cranial nerve syndromes
• post-traumatic epilepsy
• meningitis - associated with CSF leakage through nose and / or ear
• communicating hydrocephalus
• cerebral atrophy
• post-concussional syndromes
• rarely, carotico-cavernous fistulae
• head injury and hypopituitarism (1)
  • marked changes of the hypothalamo-pituitary axis have been documented in the acute phase of traumatic brain injury(TBI)
    • following TBI as many as 80% of patients showing evidence of gonadotropin deficiency, 18% of growth hormone deficiency, 16% of corticotrophin deficiency and 40% of patients demonstrating vasopressin abnormalities leading to diabetes insipidus or the syndrome of inappropriate anti-diuresis
    • longitudinal prospective studies have shown that some of the early abnormalities are transient, whereas new endocrine dysfunctions become apparent in the post-acute phase. There remains a high frequency of hypothalamic-pituitary hormone deficiencies among long-term survivors of TBI, with approximately 25% patients showing one or more pituitary hormone deficiencies
• neuro-psychological

Reference:

• 1. Behan LA et al. Neuroendocrine disorders after traumatic brain injury. J Neurol Neurosurg Psychiatry. 2008 Jul;79(7):753-9