Dados do Trabalho

Título

SHORT, MEDIUM AND LONG TERM PITUITARY NEURORRADIOLOGICAL FOLLOW-UP IN CHILDREN AND ADOLESCENTS AFTER TRAUMATIC BRAIN INJURY.

Introdução

Pituitary Radiological study is important to evaluate hypothalamus/hypophisis axis problems.
There are studies that describe correlation between pituitary radiological abnormalities and hipopituitarism at general population, but few studies describe neuroradiological abnormalities after traumatic brain injury in paediatric population, and, when they do, it´s only at isolated case reports.

Objetivo

Studying routine traumatic brain injured patients magnetic ressonance images (MRI), evaluating pituitary morphology and volume in a paediatric population.

Métodos

It is a longitudinal retrospective cases serie study, including 78 children and adolescents that are being followed at our Rehabilitation Center between 2009 and 2021.

MRI Technique 1,5 or 3,0 millimeter contiguous sagittal and coronal plain through the sella
were obtained using superconducting MRI units.

A Developmental and Rehabilitation Pediatrician has been trained by a Neurorradiologist and performed at the morphological pituitary analysis.

Pituitary volume was measured using the formula: coronal width X coronal height X sagital width X 0,5. The results were compared to pre-existing parameters for age and sex.
We used the Program AquariusNet Viwer (AqNet) Versão V4.4.13.P4 (522).

Resultados

We studied 47 males and 31 females. Some patients had more than one sequential study, so, totally, we evaluated 151 images.
Age at MRI test went from 11 months old to 18 years old.
Age at traumatic brain injury went from 0,2 to 16,9 years old.
Time after traumativ brain injury went from 0,2 to 14 follow up years.
We found pituitary abnormalitie at 29 from 123 MRI exams (23%) or in 25 from 74 patients (32%).
All patients with radiological pituitary abnormalities had previous severe traumatic brain injury, according to Glasgow Coma Scale. From those patients, 72% were females.
We found two “empty sella syndrome” situations, one caused by “pituitary stalk transection syndrome”; one pituitary cist (Rathke); and 22 cases with pituitary volume inferior to normal references.
with pituitary hormone deficiency. These abnormalities are more prevalent in MPHD. In
both adults and children, ectopic posterior pituitary bright spot (EPPBS) at the median
eminence was a universal finding in all patients.

Conclusões

Structural pituitary abnormalities have been found in 32% of our patients.
It is important to closely follow- up these patients in the long-term so that their natural history of progressive radiological and hormonal deterioration can be ascertained.

Palavras chave

Pituitary; Traumatic Brain Injury; Child; Adolescents; Magnetic Ressonance Image;

Referências (se houver)

1. Sari S, Sari E, Akgun V, Ozcan E, Ince S, Saldir M, Babacan O, Acikel C, Basbozkurt G, Ozenc S, Yesilkaya S, Kilic C, Kara K, Vurucu S, Kocaoglu M, Yesilkaya E.
Measures of pituitary gland and stalk: from neonate to adolescence.
J Pediatr Endocrinol Metab. 2014 Nov;27(11-12):1071-6. doi: 10.1515/jpem-2014-0054.
2. Kara Ö1, Esen I1, Tepe D1, Güllero¿lu NB2, Tayfun M1.
Relevance of Pituitary Gland Magnetic Resonance Imaging Results with Clinical and Laboratory Findings in Growth Hormone Deficiency.
3. Pediatr Radiol. 2018 May;48(5):694-700. doi: 10.1007/s00247-018-4070-7. Epub 2018 Mar 6.
Pituitary height at magnetic resonance imaging in pediatric isolated growth hormone deficiency.
Dumrongpisutikul N1, Chuajak A2,3, Lerdlum S2.
Med Sci Monit. 2018 Dec 30;24:9473-9478. doi: 10.12659/MSM.911977.
4. J Pediatr Endocrinol Metab. 2016 Oct 1;29(10):1195-1200. doi: 10.1515/jpem-2015-0404.
Pituitary volume in children with growth hormone deficiency, idiopathic short stature and controls.
Kessler M, Tenner M, Frey M, Noto R.

Declaração de conflito de interesses de TODOS os autores

Não temos conflito de interesses.