Hypothalamic Pituitary axis shift and problems with lexical memory and functional scanning

I was a critical care medic in FL in the back of the ambulance going code emergency with my patient when we had an accident- my head rotated and I couldn’t move my right arm or neck.I was sideways bent over and looking forward through to the front windshield.I don’t remember hitting my head.My jaw touched my shoulder and I cracked a tooth.I have herniated discs c4-5, 5-6,C2-3 and a torn supraspinatus.10 days after the accident I started lactating.I had emotional rage&confusion-I had blurred vision in my right eye and very bad headaches.I was nervous and paid for an MRI scan myself- asymmetrical sella floor- with slight abnormality of right sella sitting lower than the left  no lesion. My prolactin levels were increasing every week.My levels reached 29.9 after 35 days I was fully lactating and put on Dostinex. My progesterone dropped and my ACTH dropped to a 7. My IGF-1 levels dropped to (I am 41). 21.6ng/ ml. I am also emotionally “flat”. This is not who I was.I have: Occipital pain ,Memory recognition problems I write everything down now,Concentration problems- reading doesnt make logical sense or I get stuck on the same line.Left facial asymmetry with some paresethsia ,Not being able to recognize or read simple words- like "mow".I could spell them out but not pronounce them or know what they mean. (this has gotten better). Right arm and leg weakness with 0 reflexes  A uvula that deviates to the left .Abnormal low IGF-1 levels.Abnormal/low GH levels ,Low Progesterone (I am not in menopause) ,Increasing prolactin levels with lactation (nulligravida) ,Positive babinski bilat.Many researchers have seen this in rats- after head trauma. My testing shows impairment of auditory and visual recognition, functional scanning and lexical memory. I was having some mild olfactory symptoms as well (these seem to come with the headaches)It is one thing to damage your brain and not be aware of your changes- you suffer being completely aware that you have changed.I need a Dx.

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

I am not sure if I can provide you a diagnosis. However, there are a few things that should be evaluated if not already done. The first is that you should see an endocrinologist for the hormonal abnormalities. You will also need an MRI of your brain to evaluate the pituitary region for structural integrity.

The other is that you should have an EEG to evaluate the electrical activity of your brain. Seizures post craniocerebral trauma may occur up to 5% of patients with closed head injuries. The risk of developing seizures post injury is related to the severity of the head injury. Severe head injury is defined as loss of consciousness or amnesia. The interval between head injury and seizure development varies. If the seizure arises weeks to months after injury, it is referred to as posttraumatic epilepsy. The frequency of these seizure types tend to decrease with time. The treatment is accomplished with a single antiepileptic medication, if clinically indicated. It is important to remember that every medicine has risks and benefits. If a cortical scar for the epileptic focus is present on MRI and the seizures are not controlled with medications, surgical resection may be an option.

Memory gaps (aka traumatic amnesia) usually remain in patients with cerebral concussions. The memory gap usually spans a period from before the accident to some time following the accident. The gap may be filled with what is told to them. The severity of the head injury and the longer the gap in formation of new memories, the more likely permanent damage will be. Studies have shown that maximum degree of improvement is seen within 6 months of the injury.

Lastly, you should be evaluated by a neurologist for a thorough neurological examination and to determine if there are other clinical findings that need to be addressed.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.

[Mediconleave]

Please- there has to be someone out there that can help me.

[Mediconleave]

Dear Dr Newey-
Thank you for the answer- It is useful. Would there be significance to having an fmri or SPECT done? Thant was also mentioned to me.
Thank You.