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Spontaneous recovery from post-traumatic hypopituitarism

P Iglesias1, A Gómez-Pan, J J Diez

  • 1Department of Endocrinology and Nutrition, Hospital La Paz, Madrid, Spain.

Journal of Endocrinological Investigation
|May 1, 1996
PubMed
Summary

Exceptional recovery of pituitary function occurred in a patient with post-traumatic hypopituitarism. This case highlights the possibility of partial spontaneous resolution, emphasizing the need for ongoing endocrine assessment after head injuries.

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Area of Science:

  • Endocrinology
  • Neuroscience
  • Trauma Surgery

Background:

  • Post-traumatic hypopituitarism is a rare complication following severe head injuries.
  • Pituitary dysfunction can manifest as deficiencies in growth hormone (GH), thyroid-stimulating hormone (TSH), adrenocorticotropic hormone (ACTH), and gonadotropins (FSH, LH).
  • Central diabetes insipidus (CDI) is a common initial endocrine disturbance after traumatic brain injury.

Observation:

  • A 32-year-old male developed CDI post-head trauma, requiring desmopressin.
  • Initial endocrine assessment revealed deficiencies in GH, cortisol, TSH, FSH, and LH, with low free T4 and testosterone.
  • MRI showed a pituitary retention cyst causing sella turcica deformity.

Findings:

  • Despite initial deficits, spontaneous partial recovery of gonadal, thyroid, and adrenal function was observed at 6 months.

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  • Growth hormone (GH) response remained impaired to various stimuli, suggesting persistent pituitary and hypothalamic damage.
  • Normal prolactin (PRL) levels and response to TRH indicated preserved lactotroph function.

    • Implications:

    • This case demonstrates an unusual partial spontaneous resolution of post-traumatic hypopituitarism.
    • Periodic endocrine evaluation is crucial for patients with suspected pituitary dysfunction after head trauma.
    • Understanding recovery patterns can inform long-term management strategies for survivors of severe head injuries.