Post-Traumatic Hypopituitarism: A Neglected Consequence of Traumatic Brain Injury.

ABSTRACT

Post-traumatic hypopituitarism (PTHP), described for the first time in 1918, used to be neglected and only considered a rare consequence of traumatic brain injury (TBI). The research conducted in the past 20 years, however, elucidated that it has been significantly underestimated. A PubMed search was conducted in order to find literature on the topic of PTHP. Efforts were made to identify the wide point of view on this problem, from the historical perspective to the most recent data. The pathogenesis of PTHP is heterogenous, and various hypotheses concerning the etiology of this condition have been proposed. Unrecognized and untreated PTHP has negative socioeconomic consequences and influences the quality of life. Although a few attempts to create a screening algorithm have already been performed, there is still no clear answer regarding follow-up. The prevalence of PTHP, a rare consequence of TBI, has been significantly underestimated in the past 20 years. The issue is multifaceted so in order to make reliable guidelines a collaboration of specialists from different fields is required. Due to the increasing prevalence of TBI, and because patients after initial treatment at emergency department usually remain under control of a neurologist, both neurologists and emergency medicine specialists should be aware of clinical picture and mechanisms of PTHP.