My Latent Self Anne Ricketts

My Latent Self

Recovering My Soul After Brain Injury
Recovering My Soul After Brain Injury

Calls for PTHP Screening & Awareness of Suicide Risk Following Head Trauma

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Whilst screening for damage to the pituitary gland following head trauma is more common place in the U.S.A., further action needs to be taken to ensure that all non-specialised doctors are aware that even a bump or jolt to the head can cause serious problems, including depression and suicide. This article in ‘MailOnline’ shares a story of a mother who was never made aware of the on-going problems her son could face after falling out of a tree at seven-years-old. Her story is a very familiar one; could it be that many more deaths by suicide can also now be linked to previous head trauma?

When a child is struggling at school, unable to deal easily with stressful situations and is prone to fluctuations in mood and difficulties studying, stop and think. Has your child ever had a bump to the head? Raising awareness about the long-term consequences of a blow to the head can and does save lives. Even though this story may not ring any bells with you, we are all only too aware of the possibility of suicide in teenagers and young adults. Please share this story with others…


Depressed? Always tired? It could all be down to a childhood bump on your head

By Lynne Wallis PUBLISHED: 02:12, 7 August 2012

Experts are warning that hundreds of thousands of people may be living with the effects of post-traumatic hypopituitarism (PTHP) — damage to the pituitary gland — as a result of a head injury. The pea-sized pituitary gland is attached to the brain by a slender stalk. It is known as the ‘master gland’ as it controls the thyroid and the adrenal glands, and is responsible for our metabolism, stress and growth hormones, and the male sex hormone testosterone. Damage to the gland can occur if the blood vessels which run through the stalk are broken or squeezed by swelling of the brain, or when the brain is starved of oxygen. Damage to the pituitary gland can cause hormonal problems including impotence, depression, low libido, infertility and fatigue, [problems which can and do lead to suicide].

A million people suffer head injuries every year in the UK and 10 per cent of these are serious. The Pituitary Foundation charity estimates 25 to 30 per cent of people with serious head injuries sustain pituitary damage. However some experts warn many more might be affected — up to 100,000 because they say pituitary damage can be sustained from a bang to the forehead or back of the head, or even whiplash. And it can be years after the initial injury before a person starts to show symptoms. ‘Too many people are falling under the radar and their PTHP is not being diagnosed,’ says Tony Belli, a trauma neurosurgeon at the Queen Elizabeth Hospital in Birmingham.‘The signs of PTHP aren’t widely recognised, but sexual dysfunction is common, with around 16 per cent suffering from impotence.’

In recognition of the dangers of the condition, in 2009 the Army began screening soldiers who’d sustained serious head injuries. Meanwhile, the Football Association is re-considering its screening policy on head injuries to include pituitary damage. But experts believe this screening should be extended to everyone.

In a 2005 study published in Brain Injury, the journal of the International Brain Injury Association, 11 specialists recommended screening for PTHP after moderate-to-severe brain injury. In 2009, a group of leading Spanish endocrinologists made a similar appeal. ‘I would like to see head injury patients who aren’t feeling 100 per cent to be screened three months after the trauma,’ says Mr Belli. Certainly if a head injury patient suffers from lethargy and tiredness as a result of depression, they should be checked for pituitary gland damage, adds Dr John Newell-Price, a reader in endocrinology at Sheffield University.

A one-off screening might not be enough, says Dr Joanne Blair, an endocrinologist at Alder Hey Children’s Hospital in Liverpool. ‘Loss of function can occur over time, sometimes decades later,’ she says, suggesting regular monitoring instead.

Alarmingly, it might not take much to trigger PTHP.

Dr Blair says to damage the pituitary gland a head injury would have to be serious enough to make a person lose consciousness — even just for a moment. ‘People are surprised to know it can happen from a simple bang on the head during rugby or football, or falling out of a tree,’ she adds.

Dr Newell-Price says: ‘It is my belief the more severe the head injury, the greater the chance of damage to the gland. However, we know whiplash can severely damage the pituitary gland, as the sudden movement can sever the stalk so the gland is disconnected from the brain.’

Indeed, a 2009 study found that pituitary gland damage can be sustained by a minor cranial trauma without even having lost consciousness.

As Mr Belli suggests: ‘Mild head injury is ten times more common than severe, and we could, therefore, be looking at as many as 100,000 people a year having PTHP, most of whom will be undiagnosed. The costs to society are vast for those with PTHP: they often stop going to work and their relationships break down — divorce among all head injury cases is 60 per cent.’

The brain injury charity Headway has recently applied to the Government health watchdog NICE to recognise the condition. It has yet to hear back.

The good news is once the condition is spotted, treatment is straightforward — a patient can have hormone replacement medication.

However, the more time that has elapsed between the head injury and PTHP, the more likely it is the patient will be on medication for life.
Read more: Mail Online

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