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Impaired Pituitary Axis Following Traumatic Skull Base Fracture and Associated Brain Injury
Rajendra Prasad1, Arvind Sharma1, Atul Kumar Khare2
1Department of Neurosurgery, Sawai Man Singh Medical College, Jaipur, Rajasthan, India.
Asian Journal of Neurosurgery
|March 5, 2026
Summary
Traumatic brain injury (TBI) can cause pituitary hormone changes, with some hormones initially increasing then normalizing. Regular monitoring is crucial for managing post-TBI pituitary dysfunction and ensuring optimal patient care.
Area of Science:
- Neuroendocrinology
- Trauma Surgery
Background:
- The pituitary gland's location makes it susceptible to head trauma.
- Posttraumatic hypopituitarism, a failure of hormone production after traumatic brain injury (TBI), is often underdiagnosed.
Purpose of the Study:
- To investigate early and late alterations in pituitary hormone levels following TBI.
- To correlate these hormonal changes with patient outcomes.
Main Methods:
- A prospective study involving 150 patients with traumatic skull base fractures was conducted.
- Pituitary hormones (GH, TSH, ACTH, FSH, LH, prolactin) were measured at multiple intervals: immediately post-trauma, day 4, day 21, and 3 months post-injury.
Main Results:
- Thyroid-stimulating hormone (TSH) levels initially rose then declined by day 21 and 3 months.
- Other hormones (prolactin, LH, FSH, ACTH, GH) peaked on admission, decreased by day 4, and normalized by day 21/90.
Conclusions:
- Hormonal increases on injury day may reflect physiological adaptation.
- Post-TBI pituitary dysfunction is significant; acute treatment for some deficiencies is needed, while others require observation.
- Periodic evaluation and follow-up are essential for managing TBI patients.
