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Sequelae of head injuries

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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The long-term complications of head injury are:

  • hemisphere syndromes - hemiplegia, aphasia - dominant hemisphere, spatial neglect - non-dominant hemisphere, visual field defects; rarely, dystonia, due to damage to the deep basal ganglia
  • brainstem syndromes - limb tremor, unsteadiness of gait
  • cranial nerve syndromes
  • post-traumatic epilepsy
  • meningitis - associated with CSF leakage through nose and / or ear
  • communicating hydrocephalus
  • cerebral atrophy
  • post-concussional syndromes
  • rarely, carotico-cavernous fistulae
  • head injury and hypopituitarism (1)
    • marked changes of the hypothalamo-pituitary axis have been documented in the acute phase of traumatic brain injury(TBI)
      • following TBI as many as 80% of patients showing evidence of gonadotropin deficiency, 18% of growth hormone deficiency, 16% of corticotrophin deficiency and 40% of patients demonstrating vasopressin abnormalities leading to diabetes insipidus or the syndrome of inappropriate anti-diuresis
      • longitudinal prospective studies have shown that some of the early abnormalities are transient, whereas new endocrine dysfunctions become apparent in the post-acute phase. There remains a high frequency of hypothalamic-pituitary hormone deficiencies among long-term survivors of TBI, with approximately 25% patients showing one or more pituitary hormone deficiencies
  • neuro-psychological

Reference:


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