Background: Traumatic Brain Injury (TBI) is a leading cause of premature death and disability worldwide. The greatest challenge associated with endocrine complications in individuals with TBI is early recognition of the subtle problems and in particular at what time after trauma the diagnosis should be made.
Objective: To determine the plasma testosterone and cortisol levels in the acute subacute, and chronic phases of TBI and to proffer when hormone replacement therapy maybe imperative.
Method: Ninety six male adults without history of chronic ailment were enrolled in the study. In each case, blood was collected within 24h in the first instance, and subsequently at 1st week and 6th week of trauma. The blood samples were collected by venopuncture in heparinized bottles and centrifuged. Plasma was extracted for testosterone and cortisol measurements, stored frozen at -20oC until the samples were analyzed consecutively by ELISA method. The result obtained where compared with reference values of normal healthy adults.
Results: Eighty five of the men with moderate to severe TBI had low mean testosterone level of 3.7nmol/litre, with two of them that had burns reaching a Nadir of 1.2nmol/litre. The testosterone level became lower in one week and remained low in the six weeks of study. The remaining men with mild TBI had less lowering of testosterone level in 24h and 1 week which picked up towards normal in the 6th week of study. Most of the subjects with moderate to severe TBI had lowered cortisol levels, while those with mild TBI had increased concentrations in acute phase but normal concentrations in the subacute and chronic phases of study.
Conclusion: Data of the study suggest that TBI may cause abnormalities of testosterone and cortisol secretions. Both testosterone and cortisol deficiencies may require replacement to improve recovery and healing from the effects of TBI.