Traumatic brain injury: Endocrine consequences in children and adults
Abstract
Traumatic brain injury (TBI) is a common cause of death and disability in young adults with consequences ranging from physical disabilities to long-term cognitive, behavioral, psychological and social defects. Recent data suggest that pituitary hormone deficiency is not infrequent among TBI survivors; the prevalence of reported hypopituitarism following TBI varies widely among published studies. The most common cause of TBI is motor vehicle accidents, including pedestrian-car and bicycle car encounters, falls, child abuse, violence and sports injuries. Prevalence of hypopituitarism, from total to isolated pituitary deficiency, ranges from 5 to 90 %. The time interval between TBI and pituitary function evaluation is one of the major factors responsible for variations in the prevalence of hypopituitarism reported. Endocrine dysfunction after TBI in children and adolescents is common. Adolescence is a time of growth, freedom and adjustment, consequently TBI is also common in this group. Sports-related TBI is an important public health concern, but many cases are unrecognized and unreported. Sports that are associated with an increased risk of TBI include those involving contact and/or collisions such as boxing, football, soccer, ice hockey, rugby, and the martial arts, as well as high velocity sports such as cycling, motor racing, equestrian sports, skiing and roller skating. The aim of this paper is to summarize the best evidence of TBI as a cause of pituitary deficiency in children and adults.
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TBI can trigger substantial neuroendocrine alterations, often manifesting days to months after the initial insult.
“Beyond the immediate structural and functional cerebral damage, TBI can trigger substantial neuroendocrine alterations, often manifesting days to months after the initial insult [5,6,7].”
From Endocrine Dysfunctions After Pediatric Traumatic Brain Injury: Present Insights and Future Directions (2025) · cites this paper as [7]
During the acute phase after TBI, serum cortisol levels typically rise in response to stress and neuroinflammation, later declining towards baseline as the injury stabilizes.
“During the acute phase, serum cortisol levels typically rise in response to stress and neuroinflammation, later declining towards baseline as the injury stabilizes [7,48,49].”
From Endocrine Dysfunctions After Pediatric Traumatic Brain Injury: Present Insights and Future Directions (2025) · cites this paper as [7]
As the injury evolves, children may shift from a compensated adrenal response to partial or complete hypothalamic-pituitary-adrenal axis failure.
“As the injury evolves, children may shift from a compensated adrenal response to partial or complete hypothalamic–pituitary–adrenal axis failure [7].”
From Endocrine Dysfunctions After Pediatric Traumatic Brain Injury: Present Insights and Future Directions (2025) · cites this paper as [7]
Post-traumatic endocrine dysfunction is an underrecognized but clinically significant sequela of pediatric TBI with potential long-term consequences for growth, puberty, metabolism, and quality of life.
“Beyond acute neurological injury, post-traumatic endocrine dysfunction has emerged as an underrecognized but clinically significant sequela, with potential long-term consequences for growth, puberty, metabolism, and overall quality of life.”
From Endocrine Dysfunctions After Pediatric Traumatic Brain Injury: Present Insights and Future Directions (2025) · cites this paper as [7]
Many endocrine sequelae after pediatric TBI manifest months to years after the initial trauma, complicating timely diagnosis.
“Importantly, many endocrine sequelae manifest months to years after the initial trauma, complicating a timely diagnosis.”
From Endocrine Dysfunctions After Pediatric Traumatic Brain Injury: Present Insights and Future Directions (2025) · cites this paper as [7]
Elevated prolactin levels can disrupt the normal pulsatile secretion of GnRH, leading to reduced secretion of LH and FSH, and consequently impaired gonadal function.
“It is important to note that elevated prolactin levels can also disrupt the normal pulsatile secretion of GnRH, leading to reduced secretion of LH and FSH, and consequently resulting in impaired gonadal function [7].”
From Endocrine Dysfunctions After Pediatric Traumatic Brain Injury: Present Insights and Future Directions (2025) · cites this paper as [7]
Cellular mechanisms like apoptosis and autophagy may contribute to progressive hypothalamic-pituitary damage after TBI.
“Furthermore, cellular mechanisms like apoptosis and autophagy may contribute to progressive hypothalamic–pituitary damage [7,53,54].”
From Endocrine Dysfunctions After Pediatric Traumatic Brain Injury: Present Insights and Future Directions (2025) · cites this paper as [7]
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INVESTIGATION OF PITUITARY DYSFUNCTION IN RETIRED PROFESSIONAL SOCCER PLAYERS
Akkurt, S., Tanrıverdi, F., Kalay, N., Karaca, Z., Ünlühızarcı, K., Sucan, S., Karakuş, M., & Kelestimur, H. F. (2020) · Revista Brasileira de Medicina do Esporte · doi:10.1590/1517-869220202606215617 · Cited by 2 · see citing works
Puberty and traumatic brain injury
Ortiz, J. B., Green, T. R. F., Rampal, G., & Rowe, R. K. (2022) · Elsevier eBooks · doi:10.1016/b978-0-12-823036-7.00029-3 · Cited by 2 · see citing works
Pituitary insufficiency following traumatic thoracic injury in an adolescent male patient
Gilis‐Januszewska, A., Kluczyński, Ł., Wilusz, M., Pantofliński, J., Turek-Jabrocka, R., Pach, D., & Hubalewska–Dydejczyk, A. (2017) · Medicine · doi:10.1097/md.0000000000008406 · Cited by 2 · see citing works
Takotsubo Syndrome: A Pathway through the Pituitary Disease
Plácido, R., Martins, A. F., Martins, S. R., do Vale, S., Almeida, A. G., Pinto, F. J., & Martins, J. M. (2016) · Case Reports in Cardiology · doi:10.1155/2016/9219018 · Cited by 2 · see citing works
Endocrine consequences of traumatic brain injury. Literature review
Capatina, C. A.-M., Capatina, C. O., Chirica, V. I., & Poiană, C. (2016) · Romanian Journal of Legal Medicine · doi:10.4323/rjlm.2016.199 · Cited by 2 · see citing works
Anwer, M., Lara-Valderrábano, L., Karttunen, J., Ndode‐Ekane, X. E., Puhakka, N., & Pitkänen, A. (2019) · Journal of Neurotrauma · doi:10.1089/neu.2019.6739 · Cited by 2 · see citing works
Cammisa, I., Malavolta, E., Sodero, G., Rigante, D., & Cipolla, C. (2025) · Children · doi:10.3390/children12111484 · Cited by 1 · see citing works
“As the injury evolves, children may shift from a compensated adrenal response to partial or complete hypothalamic–pituitary–adrenal axis failure [7].”
InfluentialCrosstalk between brain and the endocrine system
Kaur, M., Prakash, K., Srivastav, S., Gadhvi, M. A., & Sharma, R. (2024) · Elsevier eBooks · doi:10.1016/b978-0-443-22268-9.00009-0 · Cited by 1 · see citing works
Bushra, S., Pawlowski, E., & Bauer, M. (2025) · Journal of Child & Adolescent Trauma · doi:10.1007/s40653-025-00713-1 · Cited by 1 · see citing works
Shin, S., Bikki, S., Byrnes, K. R., & Bandyopadhyay, B. C. (2026) · Neurochemical Research · doi:10.1007/s11064-026-04755-1 · Cited by 1 · see citing works
Collaboration for Success in Young Adults with Traumatic Brain Injury
Cechanowicz, B. (2015) · UNM’s Digital Repository (University of New Mexico)
IMPROVING TRAUMATIC BRAIN INJURY OUTCOMES THROUGH GENE THERAPY AND EXERCISE
Taylor, J. M. (2015) · KU ScholarWorks (University of Kansas)
Developing a Bicycle Helmet Program for an Urban Pediatric Emergency Department
Mulholland, J. (2015) · UA Campus Repository (The University of Arizona)
Hypopituitarism following traumatic brain injury
Attard, C. C., & Vella, S. (2015) · OAR@UM (University of Malta)
The Impact of Intrathecal Baclofen on Growth Among Children with Spasticity Ages 2-20 Years
Kaye, M., & Lynn, A. (2017)
Pituitary and Other Hormonal Derangements in Severe Traumatic Brain Injury
Pendleton, C. A., & Jallo, J. (2018) · Springer eBooks · doi:10.1007/978-3-319-89477-5_8
Neuroendocrine Dysfunction Following Concussion: A Missed Opportunity for Enhancing Recovery?
Glynn, N., & Agha, A. (2019) · Cambridge University Press eBooks · doi:10.1017/9781139696432.028
光洋, 藤., Okada, N., 佳歩, 廣., 訓生, 濱., 賢, 別., 望, 笹., & 慶, 西. (2018) · Nihon Kyukyu Igakukai Zasshi Journal of Japanese Association for Acute Medicine · doi:10.1002/jja2.12278
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Paediatric Head Injury Management
James, G. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108355247.023
Traumatic brain injuries- How can Endocrinologists help?
Jacob, J. J. (2021) · Indian Journal of Endocrinology and Metabolism · doi:10.4103/2230-8210.325715
The rate of empty sella (ES) in traumatic brain injury: Links with endocrine profiles
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Alteraciones hipofisiarias postraumáticas y trastornos cognitivos
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Smith, A. M., & Grayson, B. E. (2024) · Journal of Neuroscience Research · doi:10.1002/jnr.25364
Yeon, J. S., Kim, S. C., Kong, S. Y., Kim, E., Park, G. J., Kim, Y. M., Chai, H. S., & Kim, H. (2026) · Injury Prevention · doi:10.1136/ip-2025-045936
Endocrine therapies and hormonal dysfunction after traumatic brain injury: A scoping review
Smith, C., Zhang, Z., Ranganathan, S., & Yuen, K. C. J. (2026) · Growth Hormone & IGF Research · doi:10.1016/j.ghir.2026.101728
- Authors
- Richmond, E., & Rogol, A. D.
- Affiliations
- Hospital Nacional de Niños (CR)
- University of Virginia (US)
- Corresponding author
- Rogol, Alan D.
- Venue
- Endocrine
- Published
- 2013-09-13
- Volume
- 45
- Issue
- 1
- Pages
- 3-8
- ISSN
- 0969-711X (ISSN-L)
- 1355-008X
- 1559-0100
- OpenAlex
- W2076601163
- Semantic Scholar
- a4485e3c0efb91c07dd126f52106c6d23e3fd424
- Cited by
- 70
- References
- 42
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 3 · 2023: 5 · 2022: 6 · 2021: 4 · 2020: 6 · 2019: 7 · 2018: 4 · 2017: 8 · 2016: 7 · 2015: 12 · 2014: 2
- FWCI
- 1.03
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Endocrine (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 hormone deficiency, endocrine dysfunction, children and adolescents, sports-related head injury, motor vehicle accidents, falls
- MeSH terms
- Adolescent, Adult, Brain Injuries, Child, Hormones, Humans, Hypopituitarism, Pituitary Gland, Human Growth Hormone, Hormone Replacement Therapy
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