Spontaneous postpartum recovery of mild traumatic brain injury induced growth hormone deficiency.

Abstract

A woman in her late 20s developed persistent post-concussion symptoms (PPCS) following a mild traumatic brain injury (mTBI) sustained in a motor vehicle collision. Symptoms included daily headaches, cognitive and physical fatigue and vision disturbances, which persisted despite extensive rehabilitation and medical interventions by multiple specialists. At 20 months post-mTBI, an endocrinological assessment confirmed post-traumatic growth hormone deficiency (GHD) through provocative glucagon stimulation testing (GST) revealing a peak GH level of 1.2 µg/L, and recombinant human growth hormone (rhGH) therapy was initiated. The patient's fatigue and overall quality of life improved on treatment, but therapy was paused during pregnancy and breastfeeding. After giving birth, the patient requested a re-evaluation for GHD before resuming treatment. Remarkably, provocative testing revealed spontaneous recovery of the hypothalamic-pituitary-somatotropic axis with a peak GH level of 18.0 µg/L, and rhGH therapy was discontinued.