Chang Yi-Cheng, Tsai Jui-Chang, Tseng Fen-Yu
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, ROC.
J Formos Med Assoc. 2006 Feb;105(2):172-6. doi: 10.1016/S0929-6646(09)60341-7.
Neuropsychiatric or cognitive disturbances are common complications after traumatic brain injury. They are commonly regarded as irreversible sequelae of organic brain injuries. We report a case of hypopituitarism in a 77-year-old man who presented with long-term neuropsychiatric disturbances, including cognitive impairment, disturbed sleep patterns, personality change, loss of affect, and visual and auditory hallucinations after a traumatic subdural hemorrhage. The treatment response to hormone replacement therapy was nearly complete. Hypopituitarism is rarely considered in patients who sustain traumatic brain injury and the neuropsychiatric manifestations of posttraumatic hypopituitarism have rarely been reported. This case highlights the importance of hypopituitarism as a potential reversible cause of neuropsychiatric disturbances after traumatic brain injury.
神经精神或认知障碍是创伤性脑损伤后的常见并发症。它们通常被视为器质性脑损伤的不可逆后遗症。我们报告了一例77岁男性垂体功能减退病例,该患者在创伤性硬膜下出血后出现长期神经精神障碍,包括认知障碍、睡眠模式紊乱、人格改变、情感缺失以及视幻觉和听幻觉。激素替代疗法的治疗反应几乎是完全的。创伤性脑损伤患者很少考虑垂体功能减退,创伤后垂体功能减退的神经精神表现也鲜有报道。该病例凸显了垂体功能减退作为创伤性脑损伤后神经精神障碍潜在可逆病因的重要性。