@article{ref1,
title="Central adrenal insufficiency following traumatic brain injury: a missed diagnosis in the critically injured",
journal="Child's nervous system",
year="2017",
author="Fan, Eileen and Skippen, Peter W. and Sargent, Michael A. and Cochrane, David D. and Chanoine, Jean-Pierre",
volume="33",
number="12",
pages="2205-2207",
abstract="BACKGROUND: High-dose steroid administration is no longer recommended in the treatment of acute traumatic brain injury (TBI) as it failed to prove beneficial in improving patients' outcome. However, a masked benefit of steroid administration in TBI management was that it provided corticosteroid replacement therapy in patients with TBI-related central adrenal insufficiency. CASE PRESENTATION: We report the case of a 12-year-old boy who suffered a severe TBI from a motor vehicle accident that resulted in complete deficiency of anterior pituitary function. Central adrenal insufficiency was not ruled out by a near normal response to a low-dose ACTH test performed on D11. <br><br>CONCLUSION: Consideration should be given to the empirical treatment of TBI pediatric patients with stress doses of corticosteroids if injury to the hypothalamus or pituitary gland is possible until a formal assessment of the hypothalamic-pituitary-adrenal axis can be made.<p /> <p>Language: en</p>",
language="en",
issn="0256-7040",
doi="10.1007/s00381-017-3536-5",
url="http://dx.doi.org/10.1007/s00381-017-3536-5"
}