Hypopituitarism after traumatic brain injury in adults: Clinical guidelines of the neuroendocrinology area of the Spanish Society of Endocrinology and Nutrition (SEEN)

Traumatic brain injury (TBI) is associated with hypopituitarism with a variable inci-dence, depending on the time and methods used to diagnosis, and on factors related to the trauma, such as its severity, its anatomical location and the drugs used in the acute phase. The pituitary gland can be damaged directly by the impact or secondary to factors such as ischemia, inflammation, excitotoxicity or immunity. In acute phases ACTH deficiency is the most relevant, since failure to detect and treat it can compromise the patient's life. Clinical manifestations are typical of each hormone deficient axes, although the combination hypopituitarism-trauma has been associated with cognitive deterioration, worse metabolic profile and greater impair-ment of quality of life. One of the clinical challenges is to determine which patients benefit from a systematic hormonal evaluation, and therefore from hormone replacement, and what is the appropriate time to do so and the most suitable diagnostic methods.(c) 2023 SEEN and SED. Published by Elsevier Espana, S.L.U. All rights reserved.

Automated summary

Traumatic brain injury (TBI) is associated with hypopituitarism which can lead to various clinical manifestations. It is important to determine which patients require hormonal evaluation and replacement therapy, as well as the appropriate timing and methods for diagnosis.