Epidemiology and risk factors for hypopituitarism due to traumatic brain injury.

During the last two decades traumatic brain injury (TBI) was also found as an important cause of hypopituitarism. Although the most common causes of TBI are traffic accidents and falls, others such as blast-related injuries, acts of violence and combative sports are also considered in the etiology. TBI may lead to transient or permanent pituitary dysfunction. The definition of TBI-induced hypopituitarism cover alterations in pituitary hormone levels which may occur even after five years of injury and characterised by hormonal deficiencies but rarely recovery of some hormones during the course of the disease. It has been shown that between 5 % and 70 % of the TBI patients suffer from hypopituitarism. This large variation in the prevalence may be explained by diverse diagnostic criteria used in different studies, different time points of interventions after TBI, severity of trauma etc. Patients with advanced age, low Glasgow Coma Scale, needing intensive care unit stay, presence of skull fractures, brain edema are particularly make patients vulnerable to TBI-induced hypopituitarism.