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Table 9.5 Hypothalamic-Pituitary-Adrenal Lesions Associated with TBI (Sirois, 2009)

Lesion Causes of Injury Location of Injury
Primary Lesion (direct) Acceleration-deceleration Traumatic lesion of the stalk
Anterior lobe necrosis
Posterior lobe hemorrhage
Basal skull fracture Direct lesion to pituitary, stalk, or hypothalamus
Secondary lesion (non-direct) Brain edema
Hypoxia
Intracranial pressure
Hemorrhage
Inflammatory mediators