Pituitary Response to Traumatic Brain Injury

Abstract

There is robust evidence supporting pituitary dysfunction after traumatic brain injury (TBI) in adults. Traumatic injury to the pituitary gland and hypothalamus with subsequent hormonal abnormalities has a multifaceted pathophysiology. While TBI is among the most common health problems of childhood, the evidence for endocrinopathies has been limited until recently. In this chapter, we provide a review of the available studies regarding pituitary function following TBI. The body of literature is complicated by multiple approaches to diagnostic testing, heterogeneity in the patient population, and the severity of brain injury. There are several papers which report no pituitary deficits, likely reflecting a lower incidence of disease in the pediatric population as compared with adults. Given the significant burden of pediatric TBI, accurate and cost-effective endocrine screening recommendations are crucial. We conclude that more investigation into consistent and accurate diagnostic testing is needed. Additionally, long-term data is needed regarding the outcomes of hormone replacement in the multitude of TBI-induced pituitary deficits.