Plasma pituitary hormone levels in severe trauma with or without head injury.

In order to evaluate the effect of head injury in severely traumatized patients on the response of ACTH, GH, PRL, and TSH plasma levels, 36 patients were prospectively studied over 5 consecutive days following injury. They were divided into three groups: Group I, severe isolated head injury (n = 14); Group II, multiple injury combined with severe head injury (n = 12); Group III, multiple injury without head injury (n = 10). No significant trend was observed during the 5 consecutive days. The following changes in plasma levels were observed, compared to normal reference value (median values): ACTH was normal in the three groups; PRL was elevated in Group II and normal in the other groups; GH was elevated in all groups; TSH was elevated in Group III and reduced in Groups I and II. Intergroup comparisons showed significantly lower plasma levels for PRL (p less than 0.05) and TSH (p less than 0.01) in Groups I and II, i.e., head-injured patients, compared to Group III, i.e., traumatized patients without head injury. A relationship was observed between the severity of head injury, as expressed by Glasgow Coma Score, intracranial pressure levels, outcome, and TSH and PRL levels.