Clinical management of pituitary dysfunction after traumatic brain injury

It has been suspected for almost a century that traumatic brain injury (TBI) can produce pituitary dysfunction, but only over the recent years/last decade have we completed prospective studies that document hypothalamic-pituitary axis damage occurs after TBI. Previously, there were only case reports associating pituitary dysfunction with brain injury. In 2000, Benvenga et al.1 reviewed these case reports, raising the possibility of an association between TBI and pituitary dysfunction. He further noted that endocrine dysfunction can occur more than 10 years after the initial injury and that the injury may not have been substantial enough to require hospitalization or even be remembered by the patient. Similarly, it is only recently that a clear association has emerged between post-TBI neuroendocrine dysfunction and neurobehavioral and quality-of-life impairments, and evidence of TBI as a cause of pituitary deficiency in all age groups keeps growing.