Injuries
The thyroid gland is abundantly vascularized tissue and is located in close proximity to vital structures – the carotid arteries, trachea, and esophagus. Therefore, thyroid injuries are conditions that carry a significant threat due to the potential development of acute airway compression and/or massive bleeding. Thyroid injury is more often not an isolated condition but is combined with damage to other structures in neck trauma. Nevertheless, a pathological thyroid gland, for example, with a goiter, may be accompanied by spontaneous hemorrhage due to increased size, fragile structure, and even greater vascularization.
Traumatic damage to the thyroid gland is dangerous not only because of the possibility of compression of adjacent neck structures but also because of the development of gland dysfunction. Hemorrhages and hematomas of the thyroid gland are more often accompanied by thyrotoxicosis, regardless of whether the patient has a prior history of hyperthyroid conditions. In some cases, a crisis course may be observed – the so-called "thyroid storm," caused by a massive release of thyroid hormones into the blood from the damaged gland. Moreover, the onset of symptoms may be delayed from the initial injury by more than a day.
Post-traumatic thyrotoxicosis is transient and resolves as the hematoma subsides. More often, post-traumatic thyroid dysfunction has a triphasic course: it begins with temporary thyrotoxicosis, which transitions to hypothyroidism, followed by normalization of gland function.
In some cases, a focal hematoma or diffuse damage to the thyroid gland can cause thyroiditis – inflammation of the gland, leading to its subsequent destruction.