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Updated: Jul 6, 2026
Investigations on Alterations of Hippocampal Circuit Function Following Mild Traumatic Brain Injury
Published on: November 19, 2012
Pituitary function after moderate or severe traumatic brain injury in two pediatric reference centers in Bogotá D.C,
William Javier Morales Camacho1, Shokery Salied Awadalla Gabrial2, Claudia Irene Ibáñez3
1University Foundation of Health Sciences (FUCS) - Sociedad de Cirugía de Bogotá - Hospital de San José, Bogotá, D.C., Colombia. wjmorales@fucsalud.edu.co.
Insights
Hypopituitarism (HPPT) occurred in 5.66% of pediatric patients after moderate or severe traumatic brain injury (TBI). Growth hormone deficiency was the only identified endocrine alteration, emphasizing the need for long-term pituitary monitoring.
Area of Science:
- Pediatric Endocrinology
- Neurotraumatology
- Pediatric Critical Care
Background:
- Traumatic brain injury (TBI) is a significant cause of childhood morbidity and mortality globally.
- Hypopituitarism (HPPT) is a potential long-term complication of moderate or severe TBI in children, with reported prevalence rates varying widely.
- Growth hormone deficiency (GHD) is the most common endocrine abnormality in the chronic phase following pediatric TBI.
Purpose of the Study:
- To assess pituitary function in pediatric patients following moderate or severe TBI.
- To determine the prevalence of hypopituitarism in this cohort.
- To provide the first systematic evaluation of pituitary function post-TBI in a Colombian pediatric population.
Main Methods:
- A cohort of 53 pediatric patients (23 moderate TBI, 30 severe TBI) was studied.
- Pituitary hormone levels (TSH, FT4, IGF-1, cortisol, prolactin) were measured at least 6 months post-TBI.
- Growth hormone deficiency (GHD) was diagnosed based on IGF-1 levels and confirmed with dynamic stimulation testing.
Main Results:
- Hypopituitarism was identified in 3 out of 53 patients (5.66%).
- All identified cases of hypopituitarism were exclusively growth hormone deficiency (GHD).
- Two patients with GHD had experienced severe TBI; no other pituitary axes showed clinically significant abnormalities.
Conclusions:
- Hypopituitarism affects a small proportion of pediatric patients in the chronic phase after moderate or severe TBI.
- These findings underscore the importance of targeted endocrine evaluations for long-term follow-up.
- Structured pituitary monitoring is crucial for improving outcomes in pediatric TBI survivors.
Abstract:
Traumatic brain injury (TBI) is a major cause of morbidity and mortality in children worldwide. Hypopituitarism (HPPT) has been described as a potential long-term complication following moderate or severe TBI, with widely variable prevalence rates. The aim of this study was to evaluate pituitary function and to estimate the prevalence of hypopituitarism in pediatric patients with moderate or severe TBI followed at two referral centers in Bogotá, Colombia. A total of 53 patients with moderate (n = 23) or severe (n = 30) TBI were included. The mean age was 10.4 ± 5.5 years, and severe TBI was more frequent in males. Baseline pituitary hormone concentrations, including thyroid-stimulating hormone (TSH), free thyroxine (FT4), insulin-like growth factor 1 (IGF-1), morning cortisol, and prolactin, were assessed at least 6 months after the traumatic event. Growth hormone deficiency (GHD) was suspected in patients with IGF-1 levels ≤ - 2 standard deviations and confirmed using dynamic stimulation testing. Hormonal alterations consistent with hypopituitarism were identified in 3 of 53 patients (5.66%), all corresponding to growth hormone deficiency. Two of these patients had experienced severe TBI. No clinically relevant abnormalities were detected in the remaining pituitary axes.
Conclusions:
In this cohort, hypopituitarism was identified in a small proportion of pediatric patients evaluated beyond the acute phase of moderate or severe TBI. These findings support the consideration of targeted endocrine evaluation as part of the long-term multidisciplinary follow-up of this population.
What Is Known:
• Hypopituitarism may develop after moderate or severe traumatic brain injury (TBI) in children and adolescents, with widely variable prevalence rates reported in the literature. • Growth hormone deficiency is the most frequent endocrine alteration during the chronic phase following pediatric TBI.
What Is New:
• This is the first study conducted in a Colombian pediatric population to systematically evaluate pituitary function after moderate or severe TBI in referral centers. • What is new: A prevalence of hypopituitarism of 5.66%, exclusively due to growth hormone deficiency, was identified at least 6 months after the traumatic event, highlighting the importance of structured pituitary follow-up to reduce morbidity and improve long-term outcomes.
