#3104 Is dipsogenic diabetes insipidus the same condition as psychogenic polydipsia?

2021 ◽  
Vol 92 (8) ◽  
pp. A11.2-A11
Author(s):  
Ewelina de Leon ◽  
Graeme Yorston
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Literature Review ◽  
Diabetes Insipidus ◽  
Endocrine Disruption ◽  
Psychiatric Disease ◽  
List Type ◽  
Psychogenic Polydipsia

Objectives/AimsTraumatic brain injury is a common cause of permanent or long-term disability,1 and up to 80% of people with moderate to severe brain injury have some degree of pituitary insufficiency. Endocrine disruption has been documented in medical literature since the 1940s,2-4 where central diabetes insipidus has been described as a common transient complication which causes polydipsia (insatiable thirst). However, polydipsia can be caused by other conditions. It is classified into dipsogenic, in a syndrome of disordered thirst-regulating mechanism in patients without psychiatric disease called dipsogenic diabetes insipidus, psychogenic, as a compulsive water drinking in patients with psychiatric conditions referred to as psychogenic polydipsia or psychogenic diabetes insipidus and iatrogenic where large quantities of water are consumed for health benefits. All of which are referred to as primary polydipsia if these conditions cannot be distinguished. Dipsogenic diabetes insipidus and psychogenic polydipsia can be easily mixed up, misdiagnosed or even unrecognised, mainly because their pathophysiology is still unclear. Are these conditions different, or is there anything that can relate them to each other? With this literature review, we are aiming to find the link between subsets of polydipsia after brain trauma, to compare proposed differential diagnosis and their functionality in clinical settings.MethodA literature review was conducted following a search of MEDLINE, CINAHL Plus, APA PsycArticles, APA PsycBooks, APA PsycInfo databases from 1858 onwards.ResultsWe will present our findings from the literature review.ConclusionPolydipsia is a common clinical problem and requires careful evaluation and management to prevent long term neurological sequelae, and there are no evidence-based treatment guidelines.References National Institute of Health and Care Excellence (NICE). (2019). Head Injury. CG176. Retrieved from: https://www.nice.org.uk/guidance/cg176 Escamilla RF, Lisser H. Simmonds disease: A clinical study with revie of the literature; Differentiation from anorexia nervosa by statistical analysis of 595 cases, 101 of which were provided pathologically. The Journal of Clinical Endocrinology & Metabolism 1942;2(2):6596. Porter RJ, Miller RA. Diabetes insipidus following closed head injury. Journal of Neurology, Neurosurgery, and Psychiatry 1946;11:528562. Webb NE, Little B, Loupee-Wilson S, Power EM. Traumatic brain injury and neuro-endocrine disruption: medical and psychosocial rehabilitation. NeuroRehabilitation (Reading, Mass.) 2014;34(4):625636.

Concussion and sports-related head injury

2019 ◽  
pp. 531-536
Author(s):  
Mark Wilson
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Mild Traumatic Brain Injury ◽  
Return To Sport ◽  
Mild Head Injury ◽  
Long Term Effects ◽  
Dementia Pugilistica ◽  
Repeated Injury

Interest in concussion and sports-related injury has intensified in recent years for three main reasons: (1) it is a preventable form of brain injury; (2) there is increasing evidence that repeated injury can result in long-term neurocognitive loss; and (3) as a result there are potential medicolegal costs to organizations that, possibly inadvertently, allow this form of brain injury to occur within their sport. The long-term effects of boxing resulting in dementia pugilistica have been appreciated for some time, however the results of repeated mild head injury in other sports is now under focus. Concussion, increasingly termed mild traumatic brain injury, should be graded. Imaging, removal from, and return to sport are all discussed in this chapter.

scholarly journals Acute and Chronic Posterior Pituitary Insufficiency Among Traumatic Brain Injury Patients at a Tertiary Care Center

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A623-A623
Author(s):  
Imtiyaz Ahmad Bhat ◽  
Moomin Hussain Bhat ◽  
Shariq Rashid Masoodi ◽  
Javid Ahmad Bhat ◽  
Zafar A Shah ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Diabetes Insipidus ◽  
Hospital Stay ◽  
Tertiary Care ◽  
Posterior Pituitary ◽  
Urinary Osmolality ◽  
Pituitary Dysfunction

Abstract Background: Traumatic brain injury (TBI) is the leading cause of death and disability in young adults. Disorders of salt and water balance are the most commonly recognized medical complications in the immediate post-TBI period and contribute to early morbidity and mortality. Objective: We aimed to evaluate the prevalence of acute (during hospital stay) and chronic posterior pituitary dysfunction in patients of head injury admitted at our tertiary care hospital. Study Design: Prospective, Observational study. Participants: 136 patients, attending tertiary care in North India with TBI with radiological evidence of head injury. Methodology: The severity of brain injury was assessed by the Glasgow Coma Scale (GCS), and Modified Rankin Scale (MRS) score at the time of admission. Lab measurements, apart from routine CBC and biochemical tests, included tests of serum and urinary osmolality, serum sodium, cortisol, and thyroid function test during the hospital stay. All patients were monitored closely during the hospital stay. Surviving patients were evaluated at 3, 6, and 12 months of follow-up. Urinary output and water deprivation tests were done to determine chronic posterior pituitary dysfunction. The results were compared against normative data obtained from 25 matched, healthy controls. Serum & urinary osmolality was measure by the freezing point method. Diabetes insipidus (DI) and Syndrome of inappropriate ADH secretion (SIADH) were diagnosed according to standard criteria. Results: Of 136 patients admitted, 61 (44.85%) had a mild head injury (GCS, ≤8), 47 (35.55%) had a moderate injury (GCS, 9-12), and 27 (19.85%) had a severe injury (GCS, 13-15). DI occurred in 10 patients (7.4%), while SIADH was observed in 4 patients in the immediate TBI period. Risk factors for diabetes insipidus were GCS of ≤ 8 at admission, midline shift, and surgical intervention. DI was an independent risk factor for death. There was a negative correlation between the presence of DI and GCS score (r, -0.367). Most of the patients with DI (8 out of 10) died during the hospital stay. One patient persisted to have partial diabetes insipidus and another one SIADH at three months post-TBI; both patients had recovered at six months of follow-up. No new case of DI or SIADH occurred on the follow up to 12 months. Conclusion: The incidence of acute DI in severe head injury (GCS ≤ 8) could be an indicator of the severity of TBI, and associated with increased mortality as most of our patients died during the hospital stay.

Acquired brain injury and violent offending: prevalence and risk factors

2011 ◽  
Vol 26 (S2) ◽  
pp. 775-775 ◽  
Author(s):  
R. Faruqui
Keyword(s):  
Risk Factors ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Mental Disorder ◽  
Acquired Brain Injury ◽  
List Type ◽  
Violent Offending ◽  
History Of ◽  
Associated Risk Factors

IntroductionAcquired brain injury has been reported to be associated with violence.ObjectivesTo determine whether an association exists between acquired brain injury and violent offendingAimsStudy an association between brain injury and crime and identify associated risk factors.MethodsSystematic search of Medline, Embase, PsychInfo, CINAHL, TRIP, using terms, Acquired brain injury, traumatic brain injury (TBI), head injury, frontal lobe, crime, offending, violent offending, sexual offending, prison.ResultsA:Multiple studies reported higher life time history of head injury in prison or offender populations in comparison to control groups. Sampling bias and case definition problems have influenced reported prevalence of head injury in offender population ranging from 3.3% to 82%. Reports from secure psychiatric services identify that patients with history of head injury may be more difficult to discharge. Community based studies report cognitive damage as significant risk factor for domestic violence.B:Large scale population and military cohorts have reported a higher relative risk for criminal conviction in mild traumatic brain injury (TBI) group. TBI increases the risk of mental disorder by two-folds but also that TBI is significantly related to mental disorder with co-existing criminality.C:Childhood conduct problems, loss of a parent, substance misuse, maternal drug use in pregnancy, impaired executive cognitive functioning, structural damage to orbito-frontal and ventromedial areas, amygdala, and hippocampus are reported as risk factors for violent offending in this population group.ConclusionsThe review provides evidence for an association between brain injury and violent offending and also identifies associated risk factors.

scholarly journals Permanent central diabetes insipidus after mild head injury

2019 ◽  
Vol 12 (5) ◽  
pp. e228737 ◽  
Author(s):  
Ersen Karakilic ◽  
Serhat Ahci
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Diabetes Insipidus ◽  
Outpatient Clinic ◽  
Central Diabetes Insipidus ◽  
Bright Spot ◽  
First Year ◽  
Mild Head Injury ◽  
Severe Tbi

We report a case of a patient with mild traumatic brain injury (TBI) who was diagnosed with permanent central diabetes insipidus (DI). A 21-year-old man was admitted to our outpatient clinic with polyuria and polydipsia 1 week after a mild head injury. He was well, except for these complaints. The initial laboratory workup was consistent with DI. There was no abnormality with other laboratory and hormone values. MRI showed lack of neurohypophyseal hyperintensity with no other abnormal findings. The patient responded well to desmopressin therapy. At the first year of the diagnosis, the patient still needed to use desmopressin treatment as we concluded that DI is permanent. DI is not uncommon after TBI, but it is often seen after severe TBI. We present here an extraordinary case of developing permanent DI after mild TBI with the absence of neurohypophyseal bright spot on MRI with no other abnormal findings.

scholarly journals Schizophrenia and Hyperostosis Frontalis Interna with History of Head Injury

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Fatima Elghazouani
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Frontal Bone ◽  
Cranial Computed Tomography ◽  
Schizophrenic Disorder ◽  
History Of ◽  
The Right ◽  
The Impact

Hyperostosis frontalis interna is an irregular thickening of the frontal bone. Its etiology is unknown. It has been rarely linked with schizophrenia and head injury. Case Presentation. We describe an unusual case of a 44-year-old female with schizophrenia and hyperostosis frontalis interna having a history of head trauma. At the age of 3 years, she had a head injury that could be classified as mild traumatic brain injury. She presents a family history of schizophrenia. She was admitted for resistant schizophrenic disorder. The cranial computed tomography showed bilateral and asymmetrical hyperostosis of the frontal bone that was more pronounced on the right side. This corresponds to the impact of the trauma with frontal atrophy without any metabolic or endocrinal abnormalities. Conclusion. We surmise that the long-term pathological effects of traumatic brain injury, including hyperostosis frontalis interna, are likely to interact with genetic vulnerability and may lead to schizophrenic disorder.

scholarly journals Doctrine of head injury sequelae

2019 ◽  
Vol 21 (1) ◽  
pp. 83-89 ◽  
Author(s):  
L. B. Likhterman
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Brain Injuries ◽  
Skull Defects ◽  
Post Traumatic ◽  
Carotid Cavernous Fistulas ◽  
Radiological Grading ◽  
Diffuse Brain

In this article, we provide the definitions of “sequelae” and “complications” of traumatic brain injury (TBI). We have developed the classification principles for TBI consequences and described their clinical forms and morphological substrates. We also provide a radiological grading for assessing the severity of sequelae of focal and diffuse brain injuries. The article covers conceptual approaches, technologies, and results of their application related to leading surgically significant consequences of TBI, including carotid cavernous fistulas, chronic subdural hematomas, post-traumatic hydrocephalus, long-term basal liquorrhea, and skull defects. We have developed the doctrine of sequelae of TBI.

Long Term Symptoms and Limitations of Activity of People with Traumatic Brain Injury: A Ten-Year Follow-up

2005 ◽  
Vol 97 (1) ◽  
pp. 169-179 ◽  
Author(s):  
C. O'Connor ◽  
A. Colantonio ◽  
H. Polatajko
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Care Center ◽  
Tertiary Care ◽  
Consecutive Series ◽  
Post Injury ◽  
What Is Said

This study examined the effect of Traumatic Brain Injury 10 years post-injury. Frequencies of head injury symptoms and activity limitation by level of severity were measured in a consecutive series of 61 adults who were admitted to a tertiary-care center for traumatic brain injury. Irritability and Anxiety were the most frequently reported symptoms from the Head Injury Symptom Checklist. Bothered by noise and Bothered by light were the least frequently reported. Trouble hearing what is said in a group conversation and Trouble hearing what is said in a one-to-one conversation were the most commonly reported limitations of activity from the Health and Activity Limitations Survey. Overall, this study illustrates that symptoms remain many years following brain injury, irrespective of the injury's severity.

Long-term neuropsychological outcomes following mild traumatic brain injury

2005 ◽  
Vol 11 (3) ◽  
pp. 228-236 ◽  
Author(s):  
RODNEY D. VANDERPLOEG ◽  
GLENN CURTISS ◽  
HEATHER G. BELANGER
Keyword(s):  
Traumatic Brain Injury ◽  
Working Memory ◽  
Brain Injury ◽  
Head Injury ◽  
Mild Traumatic Brain Injury ◽  
Odds Ratio ◽  
Verbal Learning ◽  
Community Dwelling ◽  
Neuropsychological Outcomes

Mild traumatic brain injury (MTBI) is common, yet few studies have examined neuropsychological outcomes more than 1 year postinjury. Studies of nonreferred individuals with MTBI or studies with appropriate control groups are lacking, but necessary to draw conclusions regarding natural recovery from MTBI. We examined the long-term neuropsychological outcomes of a self-reported MTBI an average of 8 years postinjury in a nonreferred community-dwelling sample of male veterans. This was a cross-sectional cohort study derived from the Vietnam Experience Study. Three groups matched on premorbid cognitive ability were examined, those who (1) had not been injured in a MVA nor had a head injury (Normal Control;n= 3214), (2) had been injured in a motor vehicle accident (MVA) but did not have a head injury (MVA Control;n= 539), and (3) had a head injury with altered consciousness (MTBI;n= 254). A MANOVA found no group differences on a standard neuropsychological test battery of 15 measures. Across 15 measures, the average neuropsychological effect size of MTBI compared with either control group was −.03. Subtle aspects of attention and working memory also were examined by comparing groups on Paced Auditory Serial Addition Test (PASAT) continuation rate and California Verbal Learning Test (CVLT) proactive interference (PI). Compared with normal controls, the MTBI group evidenced attention problems in their lower rate of continuation to completion on the PASAT (odds ratio = 1.32,CI= 1.0–1.73) and in excessive PI (odds ratio = 1.66,CI= 1.11–2.47). Unique to the MTBI group, PASAT continuation problems were associated with left-sided visual imperceptions and excessive PI was associated with impaired tandem gait. These results show that MTBI can have adverse long-term neuropsychological outcomes on subtle aspects of complex attention and working memory. (JINS, 2005,11, 228–236.)

scholarly journals CT Scan importance in the first eight hours of head injury

2018 ◽  
Vol 5 (4) ◽  
pp. 766
Author(s):  
Mohammed Alfageeh ◽  
Moneerah Bahran ◽  
Sultan Albargi ◽  
Ibrahim Althomali ◽  
Adnan Alzahrani ◽  
...  
Keyword(s):  
Public Health ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Public Health Problem ◽  
Neurological Deficits ◽  
Major Public Health Problem ◽  
Adults And Children ◽  
The Brain

Traumatic brain injury following head injury is a major public health problem that can result in significant long-term morbidity and mortality among adults and children worldwide. Emergency brain imaging is necessary for individuals subjected to traumatic brain injury to early detect treatable conditions. Prompt neurosurgical management of treatable conditions can prevent further damage and secondary neurological deficits. This will subsequently improve the outcome and reduce long-term disability. Computed Tomography (CT) of the brain is the investigation of choice for assessment of patients with head injury due to its availability, advantages, and sensitivity for multiple lesions following head trauma. This article will review and discuss the importance of CT imaging in evaluating patients with traumatic brain injury, its advantages, limitations, and prognostic values.

Organic Eating Disorders of Morbid Hunger & Hyperphagia After Traumatic Brain Injury (TBI): Presentation and Prevalence

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1 ◽  
Author(s):  
R. Faruqui ◽  
A. Rowell
Keyword(s):  
Traumatic Brain Injury ◽  
Eating Disorders ◽  
Brain Injury ◽  
Head Injury ◽  
Case Reports ◽  
Tertiary Care ◽  
Case Series ◽  
List Type ◽  
Type Number ◽  
Life Threatening

Background:Morbid Hunger or persistent Hyperphagia are rare conditions after TBI and can pose life threatening health risks to the patient, risks of aggression towards professional and family carers managing this behaviour, and the ability to function in social settings.Method:1.Systematic search of Medline, Embase, PsychInfo, CINAHL, DARE, Cochrane Database of Systematic Reviews, and Cochrane Clinical Trials Register, using terms Eating Disorders, Organic Eating Disorders, Binge Eating, Anorexia Nervosa, Hyperphagia, Morbid Hunger, Satiety, Hypothalamus, Pituitary Glands, Traumatic Brain Injury, and Acquired Brain Injury.2.Diagnostic review of currently admitted hospital patients at a tertiary care brain injury rehabilitation centre in order to establish point prevalence.3.Review of Dietetic records to establish clinical presentation and management principles.Results:Systematic review identified case reports and case series of these disorders, providing description of three distinct traumatic presentations:a. Persistent Hyperphagia after head injury.b. Serious food seeking behaviour and overeating after surgery for neoplasm resulting in pituitary/ hypothalamic injury.c. Head Injury variant of Kleine Levine Syndrome presenting with Hyperphagia, Hypersomnolence, and Hypersexuality.Diagnostic review of 88 admitted patients identified 2 (3%) patients presenting with this condition.Review of dietetic records confirmed the persistent and serious nature of this presentation and identified a high need for environmental and cue exposure control in management of this condition.Conclusions:Organic eating disorders are rare but potentially life threatening conditions, requiring formal cataloguing and recognition in diagnostic classifications to facilitate systematic study of pathophysiology and relevant management strategies.

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