Anterior hypopituitarism: a consequence of head injury

Anterior pituitary insufficiency in patients with traumatic brain injury is rare. Only sporadic cases have been reported in the literature. The authors report a case of panhypopituitarism that developed in a 19-year-old man and was diagnosed six months after the patient sustained severe craniocerebral trauma in a motor vehicle accident. After an initial slow improvement in neurologic function he very gradually retrogressed in physical and mental capacities. An acute adrenal crisis led to the diagnosis of hypopituitarism. Institution of appropriate hormone therapy resulted in steady improvement in motor and cognitive functioning. The authors reviewed the literature and discuss the possible pathophysiology. They exhort physiatrists to be aware of this rare but potentially fatal consequence of craniocerebral trauma.