Table 3.

Medical complications frequently encountered after moderate to severe head injury during rehabilitation, their symptomatology, and risk factors.

Medical Complications	Symptomatology	Risk Factors	Neuroendocrine Disturbance Causing Similar Symptoms
Neuroendocrine disturbances		advanced age, injury severity, skull fractures
Hydrocephalus	(1) Reduced functioning, lethargy, nausea, vomiting (2)Gait disturbance (3)Urinary incontinence	advanced age, injury severity, intraventricular haemorrhage, subarachnoid haemorrhage, meningitis	(1)Anterior pituitary insufficiency: GH, TSH, ACTH
Post-traumatic epilepsy	(1)Seizures, (2)reduced cognitive performance, including alertness and speed of processing	skull fractures, penetrating injury, advanced age, neurological deficit	(1)hypo- or hypernatremia due to SIADH or Diabetes insipidus can trigger seizures (2)Anterior pituitary insufficiency: GH, TSH
Fatigue	anxiety, depression daytime sleepiness, diminished cognitive function	gender (female)? Pituitary dysfunction? anxiety, depression, sleep disturbances, cognitive and motor disturbance, pain	Anterior pituitary insufficiency: GH, TSH, ACTH Decreased evening melatonin synthesis (sleep disturbance)
Disorders of consciousness		Injury severity	?
Paroxysmal sympathetic hyperactivity	(1)↑ Heart rate (2)↑ Blood pressure (3)↑ Respiratory rate (4)Sweating (5)↑ Temperature (6)Posturing (7)↑ reactivity to a non-noxious stimulus	injury severity diffuse axonal injury gender (male), younger age
Psychiatric-behavioural Symptoms (Apathy, Depression, Anxiety, Agitation/Aggression)	(1)Apathy (2)Depression (3)Anxiety (4)Agitation/Aggression	(1)focal brain injury (frontal) (2)younger age, pre-injury mental health treatment, pre-injury substance abuse, gender (female) (3)older age (4)Injury severity, focal brain injury (frontotemporal) Gender (male)	(1)Anterior pituitary insufficiency: GH, TSH, ACTH (2)Anterior pituitary insufficiency: GH, TSH, ACTH (3)Anterior pituitary insufficiency: GH, TSH, ACTH (4)ACTH Insufficiency