Neuroimaging in the Detection of Endocrine Dysfunction Following Traumatic Brain Injury (Atena Editora)

Abstract

INTRODUCTION Traumatic brain injury (TBI) is a major global health issue, leading to significant morbidity and mortality. Beyond the immediate cognitive and motor impairments, TBI is often associated with endocrine dysfunctions, particularly hypopituitarism, which is frequently underdiagnosed. The pituitary gland, due to its anatomical location and vulnerability to injury, is often affected post-TBI. The introduction discusses the importance of neuroimaging techniques, such as MRI and CT, in the early detection and management of pituitary dysfunction. It highlights the need for advanced imaging modalities to improve diagnostic accuracy and patient outcomes. OBJETIVE To evaluate the role of neuroimaging techniques in the detection and management of endocrine dysfunctions, particularly pituitary insufficiency, following traumatic brain injury (TBI). METHODS This is a narrative review which included studies in the MEDLINE – PubMed (National Library of Medicine, National Institutes of Health), COCHRANE, EMBASE and Google Scholar databases, using as descriptors: “Traumatic Brain Injury” AND “Neuroimaging Techniques” AND “Pituitary Dysfunction” OR “Hypopituitarism” AND “Endocrine Dysfunction” in the last years. RESULTS AND DISCUSSION The results section delves into the prevalence of endocrine dysfunctions in TBI patients, particularly focusing on pituitary insufficiency. It reviews various neuroimaging techniques, including MRI, CT, and emerging functional imaging modalities like fMRI and PET, assessing their efficacy in detecting pituitary abnormalities. The discussion also explores the timing of imaging, the correlation between imaging findings and hormonal assays, and the role of neuroimaging in differentiating primary from secondary pituitary dysfunction. The challenges of using these techniques in clinical practice, including cost, variability in protocols, and ethical considerations, are also addressed. CONCLUSION The conclusion emphasizes the critical role of neuroimaging in the early detection and management of endocrine dysfunctions following TBI. While advances in imaging technology have improved diagnostic capabilities, challenges remain in standardizing protocols and integrating these techniques into routine clinical practice. The need for interdisciplinary collaboration, further research, and the development of guidelines to optimize the use of neuroimaging in managing TBI-related endocrine dysfunctions is highlighted. The future of neuroimaging in this context looks promising, with potential benefits for improving long-term outcomes in TBI survivors.