Traumatic Brain-Injury-Induced Hypopituitarism: Clinical Management and New Perspectives

Once being a neglected etiologic factor, traumatic brain injury is now acknowledged as an important risk factor for pituitary dysfunction. The gland might be damaged as a result of primary or secondary injury. The prevalence of pituitary dysfunction is highly variable across studies. The occurrence rate during acute and/or chronic phases was reported up to 69% in some series, while the rate of persis- tent hypopituitarism decreased to 12% when confirmatory testing was conducted. Growth hormone deficiency emerges as the most prevalent hormone deficiency subsequent to traumatic brain injury, followed by adrenocorticotropic hormone, gonadotropins (follicle-stimulating hormone and luteiniz- ing hormone), and thyroid-stimulating hormone deficiencies. Pituitary function tends to be dynamic following traumatic brain injury; hormone insufficiencies may improve, and new deficiencies may occur during follow-up. The clinical findings of pituitary hormone deficiencies may vary widely from non-specific and subtle symptoms to urgent life-threatening conditions such as hypotension and hyponatremia. Timely diagnosis is of utmost importance, and it requires awareness and a high level of suspicion. Screening algorithms have been developed to guide clinicians on who should be tested for pituitary dysfunction, how, and for how long following traumatic brain injury. However, the rate of routine screening is still low among clinicians. We aimed to review the current literature focusing on the diagnosis and clinical management of pituitary dysfunction following traumatic brain injury.

Cite this article as: Hacıoğlu A, Tanrıverdi F. Traumatic brain-injury-induced hypopituitarism: Clinical management and new perspectives. Endocrinol Res Pract. 2023;27(3):164-172.