Traumatic brain injury-induced hypopituitarism in adolescence

Childhood hypopituitarism may be present at birth or may be acquired. Young children and teenagers are particularly susceptible to TBI; in fact TBI is one of the first causes of death and disability in children older than one month of age since the most common cause of TBI is car crashes, including pedestrian-car and bicycle-car encounters, falls, child abuse, violence and sports injuries. Furthermore younger kids are more likely to have TBI due to falls while teenagers have more TBI than any other population from motor vehicle crashes. As reported for the adult patients hypopituitarism in adolescence should be suspected within an appropriate clinical context. In adolescents affected by TBI no experience about this condition has been reported but it is well known that treatment of hypopituitarism, in particular of GH deficiency, has multiple beneficial effects in addition to its promotion of linear growth and in particular in the transition phase. These include maintenance of normal body composition, structure function and metabolism through adult life. Therefore, the onset of TBI-induced GH deficiency in this particular phase of life should be strictly evaluated and corrected for the possible adult health consequences.