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Cited by 69Pituitary Gland Disorders and TreatmentsTraumatic Brain Injury and Neurovascular DisturbancesTraumatic Brain Injury Research

Pituitary pathology in traumatic brain injury: A review

Sav, Aydin, Rotondo, Fabio, Syro, Luis V., Serna, Carlos A., Kovacs, Kalman·2019·Pituitary
DOI 10.1007/s11102-019-00958-8
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Abstract

Purpose Traumatic brain injury most commonly affects young adults under the age of 35 and frequently results in reduced quality of life, disability, and death. In long-term survivors, hypopituitarism is a common complication.Results Pituitary dysfunction occurs in approximately 20-40% of patients diagnosed with moderate and severe traumatic brain injury giving rise to growth hormone deficiency, hypogonadism, hypothyroidism, hypocortisolism, and central diabetes insipidus. Varying degrees of hypopituitarism have been identified in patients during both the acute and chronic phase. Anterior pituitary hormone deficiency has been shown to cause morbidity and increase mortality in TBI patients, already encumbered by other complications. Hypopituitarism after childhood traumatic brain injury may cause treatable morbidity in those survivors. Prospective studies indicate that the incidence rate of hypopituitarism may be ten-fold higher than assumed; factors altering reports include case definition, geographic location, variable hospital coding, and lost notes. While the precise pathophysiology of post traumatic hypopituitarism has not yet been elucidated, it has been hypothesized that, apart from the primary mechanical event, secondary insults such as hypotension, hypoxia, increased intracranial pressure, as well as changes in cerebral flow and metabolism may contribute to hypothalamic-pituitary damage. A number of mechanisms have been proposed to clarify the causes of primary mechanical events giving rise to ischemic adenohypophysial infarction and the ensuing development of hypopituitarism.Conclusion Future research should focus more on experimental and clinical studies to elucidate the exact mechanisms behind post-traumatic pituitary damage. The use of preventive medical measures to limit possible damage in the pituitary gland and hypothalamic pituitary axis in order to maintain or re-establish near normal physiologic functions are crucial to minimize the effects of TBI.

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  • Such damage leads to impaired secretion of luteinizing hormone and follicle-stimulating hormone, ultimately causing delayed onset or interruption in the progression of secondary sexual characteristics.

    “Such damage leads to impaired secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), ultimately causing delayed onset or interruption in the progression of secondary sexual characteristics [41,42,43].”

    From Endocrine Dysfunctions After Pediatric Traumatic Brain Injury: Present Insights and Future Directions (2025) · cites this paper as [42]

  • Bellone et al. evaluated 70 children between 1 and 9 years after TBI and identified four cases of ACTH deficiency, some in combination with other pituitary deficits; at one year, 10% of the cohort had at least one hypothalamic-pituitary hormone abnormality.

    “Bellone et al. evaluated 70 children between 1 and 9 years after TBI and identified four cases of ACTH deficiency, some in combination with other pituitary deficits. At one year, 10% of the cohort had at least one hypothalamic–pituitary hormone abnormality [42].”

    From Endocrine Dysfunctions After Pediatric Traumatic Brain Injury: Present Insights and Future Directions (2025) · cites this paper as [42]

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Authors
Sav, A., Rotondo, F., Syro, L. V., Serna, C. A., & Kovacs, K.
Affiliations
  • St. Michael's Hospital (CA)
  • Hospital Pablo Tobon Uribe (CO)
  • Universidad CES (CO)
ORCID
Venue
Pituitary
Publisher
Springer Science and Business Media LLC
Published
2019-03-29
Volume
22
Issue
3
Pages
201-211
ISSN
  • 1386-341X (ISSN-L)
  • 1573-7403
DOI
10.1007/s11102-019-00958-8
OpenAlex
W2926840448
Semantic Scholar
bf0f7b5114e975878d5af63c088b85892feb4437
Cited by
69
References
116
Citations by year
2026: 5 · 2025: 16 · 2024: 9 · 2023: 9 · 2022: 10 · 2021: 9 · 2020: 10 · 2019: 1
FWCI
1.15
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • Pituitary (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
  • Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
  • Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
Keywords
traumatic brain injury, hypopituitarism, pituitary dysfunction, growth hormone deficiency, hypogonadism, hypothyroidism, adrenal insufficiency, central diabetes insipidus, hypothalamic-pituitary axis, secondary brain injury, pathophysiology
MeSH terms
Brain Injuries, Traumatic, Animals, Female, Humans, Hypopituitarism, Hypothalamus, Male, Pituitary Gland, Autoimmunity

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