Hypothalamic atrophy presenting as amenorrhea and sexual infantilism in a female adolescent. A case report

A 17-year-old girl presented with amenorrhea, sexual immaturity and a remote history of head trauma. Provocative testing of the pituitary with thyrotropin releasing hormone, gonadotropin releasing hormone and insulin-induced hypoglycemia revealed intact pituitary function, with hypothalamic insufficiency. Furthermore, magnetic resonance imaging of the brain demonstrated loss of the hypothalamic infundibulum. To our knowledge, these structural defects have not been found with magnetic resonance imaging in cases of hypothalamic atrophy. This case suggests that the infundibulum or pituitary stalk may be vulnerable to traumatic damage, leading to hypothalamic insufficiency persisting into adulthood.