title: Hypopituitarism following a direct bullet injury to the pituitary. A case report.
abstract: A 29-year old man was referred for hypogonadism. At 14 years of age he was struck by a gun bullet in the head, receiving a frontomedial open fracture with leakage of cerebral tissue. The bullet could not be extracted at the operation. At 16 years of age he noticed a stop of pubertal development, weight gain and a fall in visus on the left eye. The clinical examination and the endocrinological data (low F-T4 and F-T3; low plasma cortisol and testosterone; normal plasma prolactin; sub-normal pituitary response to intravenous administration of insulin, GnRH, TRH and GRF) demonstrated that the patient was hypopituitaric. A radiological skull X-ray showed that the bullet was lodged in the sellar and parasellar region. This seems to be the seventh case of hypopituitarism following a direct injury to the pituitary region described in the literature so far.
authors.forename: G
authors.initials: G
authors.lastname: Lo Iudice
authors.forename: B
authors.initials: B
authors.lastname: D'Alessandro
authors.forename: V
authors.initials: V
authors.lastname: Esposito
authors.forename: P
authors.initials: P
authors.lastname: Federico
authors.forename: R
authors.initials: R
authors.lastname: Mignini
authors.forename: C
authors.initials: C
authors.lastname: Rispoli
mesh_terms: D000328:Adult; D006801:Humans; D007018:Hypopituitarism / Q000209:etiology*; D008297:Male; D010902:Pituitary Gland / Q000293:injuries*; D014948:Wounds, Gunshot / Q000150:complications*