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Pituitary

pp 1–12 | Cite as

The frequency and the diagnosis of pituitary dysfunction after traumatic brain injury

  • Nigel Glynn
  • Amar AghaEmail author
Article

Abstract

Purpose

Clinical research studies over the last 15 years have reported a significant burden of hypopituitarism in survivors of traumatic brain injury (TBI). However, debate still exists about the true prevalence of hypopituitarism after head injury.

Methods

We have reviewed the literature describing the frequency of post-traumatic hypopituitarism and discuss the factors which may explain the variable frequency of the reported deficits in clinical studies including research methodology and the natural history of the disease.

Results

Pituitary hormone perturbations in the acute phase following injury are frequent but are difficult to attribute to traumatic pituitary damage due to physiological hormonal changes in acute illness, the confounding effect of medications, other co-morbidities and lack of appropriate control subjects. Nevertheless, a small number of studies have emphasised the clinical importance of acute, dynamic disturbance of the hypothalamic–pituitary–adrenal axis. There is a much larger evidence base examining the frequency of hypopituitarism in the chronic, recovery phase following head injury. These studies report a very broad prevalence of long-term pituitary hormone dysfunction in survivors of TBI. However, systematic review suggests the prevalence to be between 27 and 31%.

Conclusion

Survivors of head injury are at risk of pituitary hormone dysfunction and we suggest an approach to the diagnosis of post-traumatic hypopituitarism in routine clinical practice.

Keywords

Hypopituitarism Traumatic brain injury Post-traumatic hypopituitarism 

Notes

Compliance with ethical standards

Conflict of interest

The authors report no conflict of interests.

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of EndocrinologySaint Bartholomew’s HospitalLondonUK
  2. 2.Academic Department of EndocrinologyBeaumont Hospital and the RCSI Medical SchoolDublin 9Ireland

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