Pituitary dysfunction after traumatic brain injury: prevalence and screening strategies

Expert Rev Endocrinol Metab. 2020 Sep;15(5):341-354. doi: 10.1080/17446651.2020.1810561. Epub 2020 Sep 23.

Abstract

Introduction: Pituitary gland is vulnerable to traumatic brain injury (TBI). As a result a series of neuroendocrine changes appear after head injury; in many occasions they reverse with time, while occasionally new late onset changes may develop.

Areas covered: In this review, we focus on the prevalence of anterior and posterior pituitary hormonal changes in the acute and chronic post-TBI period in both children and adults. Moreover, we present evidence supporting the need for evaluating pituitary function along with the current suggestions for the most appropriate screening strategies. We attempted to identify all published literature and we conducted an online search of PubMed, from January 1970 to June 2020.

Expert opinion: Adrenal insufficiency and water metabolism disorders are medical emergencies and should be promptly recognized. Awareness for long-term hormonal derangements is necessary, as they may lead to a series of chronic health issues and compromise quality of life. There is a need for well-designed prospective long-term studies that will estimate pituitary function during the acute and chronic phase after head injury.

Keywords: Pituitary dysfunction; hypopituitarism; neuroendocrine; traumatic brain injury.

Publication types

  • Review

MeSH terms

  • Adrenal Insufficiency / epidemiology
  • Adrenal Insufficiency / etiology*
  • Adrenal Insufficiency / pathology
  • Brain Injuries, Traumatic / complications*
  • Humans
  • Hypopituitarism / epidemiology
  • Hypopituitarism / etiology*
  • Hypopituitarism / pathology
  • Prevalence
  • Quality of Life
  • Risk Factors