Hypopituitarism following traumatic brain injury

Abstract

Traumatic brain injury (TBI) is a worldwide public health problem and an important cause of hypopituitarism. The incidence of hypopituitarism following moderate to severe TBI varies in different studies and may occur as multiple or isolated hormonal deficiencies, with gonadotrophin and growth hormone insufficiencies predominating, particularly in the acute setting. Adrenocorticotropic hormone deficiency is also common during the recovery phase. Pituitary function assessment in the acute phase post TBI is subject to multiple caveats and pitfalls due to hormonal alterations which occur as normal physiological responses to critical illness and the effects of drugs that are used in the intensive care unit. Nonetheless, assessment of the hypothalamo-pituitary-adrenal axis is of paramount importance during this period. Predictors of hypopituitarism during the acute phase of TBI remain unclear - further research is warranted.