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Pituitary

, Volume 22, Issue 3, pp 261–269 | Cite as

Clinical picture and the treatment of TBI-induced hypopituitarism

  • Marina CaputoEmail author
  • C. Mele
  • F. Prodam
  • P. Marzullo
  • G. Aimaretti
Article
  • 109 Downloads

Abstract

Traumatic brain injury (TBI) is an important public health problem with an increasing incidence in the last years. Relatively few cases are fatal; most individuals will survive and, in the long-term, the sequalae of TBI will include neuroendocrine dysfunctions with a much higher frequency than previously suspected. Patients who develop hypopituitarism after TBI present manifestations due to the number of deficient hormones, severity of hormonal deficiency, and the duration of hypopituitarism without diagnosis and treatment. The clinical spectrum of hypopituitarism is very large and many signs and symptoms of TBI survivors such as fatigue, concentration difficulties, depressive symptoms are nonspecific and overlap with symptoms of post-traumatic stress disorder and variably severe hypopituitarism related to brain damage remaining undiagnosed. This can explain why the diagnosis of hypopituitarism is often missed or delayed after this condition with potentially serious and hazardous consequences for the affected patients. Moreover, clinical experience cumulatively suggests that TBI-associated hypopituitarism is associated with poor recovery and worse outcome, since post-traumatic hypopituitarism is independently associated with cognitive impairment, poor quality of life, abnormal body composition, and adverse metabolic profile. In the present review, the current data related to clinical consequences of pituitary dysfunction after TBI in adult patients and therapeutic approaches are reported.

Keywords

Traumatic brain injury Hypopituitarism Replacement therapy 

Notes

Compliance with ethical standards

Conflict of interest

Caputo M, Mele C, Prodam F, Marzullo P, Aimaretti G declare they have no conflict of interest.

Ethical approval

This article does not contain any studies with animals performed by any of the authors.

Research involving human and animal participants

This article does not contain any studies with human participants or animals performed by any of the authors.

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Authors and Affiliations

  1. 1.Endocrinology, Department of Translational MedicineUniversità del Piemonte OrientaleNovaraItaly
  2. 2.Interdisciplinary Research Center of Autoimmune DiseasesUniversità del Piemonte OrientaleNovaraItaly
  3. 3.Department of Health ScienceUniversità del Piemonte OrientaleNovaraItaly
  4. 4.Division of General MedicineI.R.C.C.S. Istituto Auxologico Italiano, Ospedale San Giuseppe VerbaniaVerbaniaItaly

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