Provisional Damages and Brain Trauma
It has been brought to our attention that there is some unawareness about the high risk of pituitary dysfunction following traumatic brain injury, which can devastate sexual function and fertility and cause depression.
Other symptoms include growth failure in children, weight problems, prolactinaemia, muscle loss, fatigue, headache, abdominal pain and weakness. Click here for a full list of symptoms
This systematic review by Schneider (JAMA 2007) covers 1137 patients and 19 studies and gives a pooled prevalence of 27.5% after mod/severe traumatic brain injury, 47% for subarachnoid haemorrhage.
The high risk of post-traumatic hypopituitarism in adults is well established yet the condition is still under-diagnosed. The situation with childhood post-traumatic hypopituitarism is even less satisfactory. Few physicians take this risk seriously apparently because most children grow normally after brain injury so it is thought that all is well. However as the following article (GGH 2008) stresses, "it is necessary for physicians . . to know that the onset of hypothalamic-pituitary deficits can occur even after several years . ."
Mild head injury sometimes causes hypopituitarism also. What is most pertinent with all degrees of head injury is that the medical profession must be aware of these risks and test where necessary. Since the onset of symptoms may be delayed, it may be in the best interests of your clients to opt for provisional damages as opposed to a lump sum, and establish a regime of regular endocrine checks so that a further contingency award can be made if the medical diagnosis supports it.
Download article: Ten Papers on Post-Traumatic Hypopituitarism
We would like to thank Joanna Lane for bringing these matters to our attention so that we too can be associated with her achievements in bringing these important findings to the fore.
Please read her story here.