title: Hypopituitarism in childhood and adolescence following traumatic brain injury: the case for prospective endocrine investigation.
abstract: Pituitary dysfunction is now well recognised after traumatic brain injury (TBI) in adults; however, little except anecdotal evidence is known about this potential complication in childhood and adolescence. Histopathological evidence exists for both hypothalamic and pituitary damage, but few data specific to children have been published. We review the available paediatric data, which shows that after both mild and severe TBI, hypopituitarism may occur, with GH and gonadotrophin deficiencies appearing to be most common. Precocious puberty has also been documented. Road-traffic accidents, falls, sport and child abuse are the most common aetiological factors for paediatric TBI. There are no published data on the incidence or prevalence, neither within a population of children with TBI, of hypopituitarism, nor on its natural history or response to hormone replacement. We urge paediatric endocrinologists, in collaboration with adult endocrinologists, to perform formal prospective research studies in patients suffering from TBI to clarify these questions.
authors.affiliation: Department of Paediatrics, University of Cambridge, Cambridge, UK.
authors.forename: Carlo L
authors.initials: CL
authors.lastname: Acerini
authors.forename: Robert C
authors.initials: RC
authors.lastname: Tasker
authors.forename: Simonetta
authors.initials: S
authors.lastname: Bellone
authors.forename: Gianni
authors.initials: G
authors.lastname: Bona
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Thompson
authors.forename: Martin O
authors.initials: MO
authors.lastname: Savage
mesh_terms: D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D003919:Diabetes Insipidus / Q000209:etiology; D005260:Female; D006801:Humans; D007018:Hypopituitarism / Q000175:diagnosis / Q000209:etiology*; D007031:Hypothalamus / Q000503:physiopathology; D007223:Infant; D008297:Male; D008487:Medical History Taking / Q000592:standards; D010902:Pituitary Gland / Q000503:physiopathology; D011629:Puberty, Precocious / Q000209:etiology; D006113:United Kingdom / Q000453:epidemiology