Endocrine dysfunction in acute brain injury

Endocrine dysfunction is a common problem in acute brain injury patients. Various mechanisms have been described as responsible for disruptions to the neuroendocrine system. They can result from increased intracranial pressure, hypoxia, inflammation, or the direct mechanical impact of high-energy trauma. Clinical features of hormonal disorders associated with traumatic brain injury, acute stroke, and subarachnoid hemorrhage are numerous. Furthermore, presented symptoms may appear unspecific and be overlooked, especially in comatose or mechanically ventilated patients. The cautious diagnostic and therapeutic approach is extremely important and, in some cases, may be life-saving. Appropriate management of endocrine dysfunction following acute brain injury is essential for an improved future outcome. Current research concentrates predominantly on the prognostic value of endocrine disorders. Specific recommendations for diagnostic and therapeutic work-up designed for acute brain injury patients are still missing.