Appelbaum Rachel D, Neri Kristina E, Rebo Kristin A, Carmichael Samuel P
Wake Forest School of Medicine, Department of Surgery, Winston-Salem, NC, USA.
Wake Forest School of Medicine, Winston-Salem, NC, USA.
Trauma Case Rep. 2022 Mar 1;38:100628. doi: 10.1016/j.tcr.2022.100628. eCollection 2022 Apr.
A 34-year-old healthy male presented as a trauma activation after sustaining a gunshot wound to his face. CT head imaging was suggestive of a ballistic fragment adjacent to a posterior wall sphenoid sinus fracture with likely a small volume of adjacent blood products. He was ultimately diagnosed with hypopituitarism which included central diabetes insipidus, central hypothyroid, and adrenocorticotropic hormone deficiency secondary to cortisol deficiency. This case illustrates the spectrum of endocrine dysfunction that can occur with skull base injuries, and the appropriate pituitary-function screening and treatment that should be performed if there is clinical concern. Early recognition and prompt treatment of pituitary insufficiency can facilitate overall rehabilitation after TBI.
一名34岁健康男性在面部遭受枪伤后被作为创伤紧急情况送来。头颅CT成像提示蝶窦后壁骨折附近有弹道碎片，可能伴有少量相邻的血液制品。他最终被诊断为垂体功能减退，包括中枢性尿崩症、中枢性甲状腺功能减退以及继发于皮质醇缺乏的促肾上腺皮质激素缺乏。该病例说明了颅底损伤可能出现的内分泌功能障碍范围，以及在临床存在疑虑时应进行的适当垂体功能筛查和治疗。早期识别和及时治疗垂体功能不全有助于颅脑损伤后的全面康复。
