Water, Salt, and Trauma: Unveiling Posterior Pituitary Dysfunction Following Traumatic Brain Injury

Dr. Kiran Kumar Nelapati, Dr. KVV Sathyanarayana Murthy, Dr. G. Satyanavamani, Dr. Ch. Meghana

Abstract: Objectives: The posterior pituitary gland (neurohypophysis) and its controlling hypothalamic nuclei are uniquely vulnerable to mechanical trauma. The infundibular stalk can be sheared, compressed, or rendered ischemic by acceleration-deceleration forces, transient intracranial hypertension, or localized cerebral edema. The resulting clinical spectrum primarily manifests as disorders of water and salt balance: diabetes insipidus (DI), caused by deficient arginine vasopressin (AVP) secretion; the syndrome of inappropriate antidiuretic hormone secretion (SIADH), characterized by excessive unsuppressed AVP action; and cerebral salt wasting (CSW), a distinct state of hypovolemic hyponatremia driven by exaggerated natriuresis. While transient disruptions in the neuro-intensive care unit are well-documented, the true prevalence of long-term, permanent posterior pituitary injury remains uncertain. Subclinical or partial forms of AVP deficiency often escape standard biochemical observation, presenting as subtle symptoms masked by cognitive or physical rehabilitation demands. This study aims to define both the acute and chronic prevalence profiles of posterior pituitary injury in moderate and severe TBI survivors. Material and Methods: This prospective study evaluated 82 consecutive survivors of moderate or severe TBI who completed neuro-rehabilitation and were available for formal endocrine reassessment at a median follow-up interval of 6 months post-trauma. Results were benchmarked against 18 healthy, age- and sex-matched controls. TBI severity was established using the post-resuscitation, pre-sedation Glasgow Coma Scale (GCS) score: Severe TBI (GCS

Keywords: Traumatic brain injury, Posterior pituitary dysfunction, Diabetes insipidus, Syndrome of inappropriate antidiuretic hormone secretion, Cerebral salt wasting, Water deprivation test

How to Cite?: Dr. Kiran Kumar Nelapati, Dr. KVV Sathyanarayana Murthy, Dr. G. Satyanavamani, Dr. Ch. Meghana, "Water, Salt, and Trauma: Unveiling Posterior Pituitary Dysfunction Following Traumatic Brain Injury", Volume 15 Issue 9, September 2026, International Journal of Science and Research (IJSR), Pages: 1676-1679, https://www.ijsr.net/getabstract.php?paperid=SR26925232203, DOI: https://dx.doi.org/10.21275/SR26925232203

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