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J. Clin. Med. 2015, 4(7), 1463-1479; doi:10.3390/jcm4071463

Impaired Pituitary Axes Following Traumatic Brain Injury

Department of Neurosurgery and the Kenneth R. Peak Brain and Pituitary Tumor Treatment Center, Houston Methodist Neurological Institute, 6560 Fannin St. Suite 944, Houston, TX 77030, USA
These authors contributed equally to this work.
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Academic Editors: Anna Kopczak and Günter Stalla
Received: 19 May 2015 / Revised: 29 June 2015 / Accepted: 6 July 2015 / Published: 13 July 2015
(This article belongs to the Special Issue Neuroendocrine Disturbances after Brain Damage)
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Abstract

Pituitary dysfunction following traumatic brain injury (TBI) is significant and rarely considered by clinicians. This topic has received much more attention in the last decade. The incidence of post TBI anterior pituitary dysfunction is around 30% acutely, and declines to around 20% by one year. Growth hormone and gonadotrophic hormones are the most common deficiencies seen after traumatic brain injury, but also the most likely to spontaneously recover. The majority of deficiencies present within the first year, but extreme delayed presentation has been reported. Information on posterior pituitary dysfunction is less reliable ranging from 3%–40% incidence but prospective data suggests a rate around 5%. The mechanism, risk factors, natural history, and long-term effect of treatment are poorly defined in the literature and limited by a lack of standardization. Post TBI pituitary dysfunction is an entity to recognize with significant clinical relevance. Secondary hypoadrenalism, hypothyroidism and central diabetes insipidus should be treated acutely while deficiencies in growth and gonadotrophic hormones should be initially observed. View Full-Text
Keywords: traumatic brain injury; hypopituitarism; head trauma; pituitary deficiency traumatic brain injury; hypopituitarism; head trauma; pituitary deficiency
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Scranton, R.A.; Baskin, D.S. Impaired Pituitary Axes Following Traumatic Brain Injury. J. Clin. Med. 2015, 4, 1463-1479.

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