An Approach to Traumatic Brain Injury-Related Hypopituitarism: Overcoming the Pediatric Challenges
Open accessAbstract
Traumatic brain injury (TBI)-related hypopituitarism is a rare polymorphic complication of brain injury, with very little data, particularly concerning children and teenagers. This is a comprehensive review of the literature regarding this pathology, starting from a new pediatric case. The research was conducted on PubMed and included publications from the last 22 years. We identified nine original studies on the pediatric population (two case reports and seven studies; only four of these seven were prospective studies). TBI-related hypopituitarism is associated with isolated hormonal deficits ranging from 22.5% to 86% and multiple hormonal deficiencies from 5.9% to 50% in the studied pediatric population. Growth hormone (GH) deficiency is most often found, including the form with late occurrence after TBI; it was described as persistent in half of the studies. Thyroid-stimulating hormone (TSH) deficiency is identified as a distant complication following TBI; in all three studies, we identified this complication was found to be permanent. Adrenocorticotropic hormone (ACTH) deficiency did not relate to a certain type of brain trauma, and it was transient in reported cases. Hyperprolactinemia was the most frequent hormonal finding, also occurring late after injury. Central diabetes insipidus was encountered early post-TBI, typically with a transient pattern and did not relate to a particular type of injury. TBI-related hypopituitarism, although rare in children, should be taken into consideration even after a long time since the trauma. A multidisciplinary approach is needed if the patient is to safely overcome any acute condition.
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- Authors
- Vlad, R. M., Albu, A. I., Nicolaescu, I. D., Dobritoiu, R., Carsote, M., Sandru, F., Albu, D., & Păcurar, D.
- Affiliations
- Carol Davila University of Medicine and Pharmacy (RO)
- St. Mary Medical Clinic, 011172 Bucharest, Romania
- Department of Pediatrics, “Grigore Alexandrescu” Emergency Children’s Hospital, 011743 Bucharest, Romania
- Department of Endocrinology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Dermatovenerology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Corresponding author
- Vlad, Raluca Maria
- Albu, Alice Ioana
- ORCID
- Venue
- Diagnostics
- Publisher
- MDPI AG
- Published
- 2023-01-06
- Volume
- 13
- Issue
- 2
- Pages
- 212
- ISSN
- 2075-4418 (ISSN-L)
- PMC
- PMC9857786
- OpenAlex
- W4313646339
- Cited by
- 7
- References
- 27
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 2
- FWCI
- 1.42
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Diagnostics (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- 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 › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
- Keywords
- traumatic brain injury, hypopituitarism, pediatric patients, growth hormone deficiency, thyroid-stimulating hormone deficiency, ACTH deficiency, hyperprolactinemia, central diabetes insipidus, multidisciplinary management
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