Hypopituitarism After Brain Injury: Clinical Relevance and Practice Guidelines

Background: Traumatic brain injury (TBI) is the most common cause of death and disability in young adults living in industrialised countries. Over the last few years, there has been an increasing awareness that hypopituitarism can complicate TBI in a significant proportion of survivors: at least 25% of TBI survivors develop one or more pituitary hormone deficiencies. This remarkably high frequency has changed the traditional concept that hypopituitarism was a rare complication of TBI and suggests that most cases of posttraumatic hypopituitarism remain undiagnosed and untreated in clinical practice. It is therefore reasonable to infer that posttraumatic hypopituitarism may make an important contribution to the high rates of physical and neuropsychiatric morbidity in patients with head injury. Conclusions: There is clearly a need for identification as well as appropriate and timely management of hormone deficiencies in TBI patients to reduce morbidity, aid recovery and rehabilitation and avoid the long-term complications of pituitary failure.