Post-Traumatic Hypopituitarism

Traumatic brain injury (TBI) frequently effects the integrity and function of the anterior and/or posterior pituitary gland. This review will cover the current understanding of post-trauma hypopituitarism (PTHP) including frequency, risk factors, screening, and treatment.

There is continuingly increased data on frequency of hormone deficiencies over time. This has created a push for algorithms to guide screening. Oxytocin is emerging as a potential target for treatment, but data is mixed and no treatment has been tested. There is significantly increased data regarding the long-term effect of growth hormone (GH) deficiency on metabolism and on the liver, which is driving renewed recommendations for consideration of GH replacement.

Pituitary dysfunction after TBI is frequent and has significant impact on morbidity, mortality, and recovery. If recognized, basic treatment is straightforward, though many gaps remain in our knowledge. Future work should focus on ideal screening strategies and treatment optimization.