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Traumatic Brain Injury - Hypothalamic - Pituitary Dysfunction

Karns & Kerrison

When a traumatic brain injury occurs, the same injury to the brain can cause damage to the hypothalamus and/or the pituitary gland. The hypothalamus is located at the base of the center of the brain. The pituitary gland is a small structure at the base of the brain below the hypothalamus.

The injury that causes the traumatic brain injury can also cause damage to the hypothalamus and/or the pituitary gland located at the base of the brain. Hypothalamic-pituitary dysfunction is known as hypopituitarism (PTHP).

PTHP has been observed in many patients suffering from a traumatic brain injury. The severity of the TBI seems to be an important risk factor for developing PTHP; however, PTHP can also manifest after mild TBI.

Changes in pituitary hormones secretion may be observed during the acute phase post-TBI, representing part of the acute adaptive response to the injury. Moreover, diminished pituitary hormone secretion, caused by damage to the pituitary and/or hypothalamus, may occur at any time after the TBI.

Patients with TBI-related hypopituitarism should be referred to an endocrinologist by their neurologist. Hypopituitarism is a condition in which the pituitary gland does not produce normal amounts of some or all of its hormones. This lack of hormone production leads to a loss of function in the gland or organ that it controls.

Depending on the hormones that are not being produced there are many symptoms that can occur including:

  • Abdominal pain
  • Decreased appetite
  • Fatigue
  • Headache
  • Lack of sex drive
  • Loss of hair
  • Sensitivity to cold
  • Vision problems
  • Weakness
  • Weight loss

Research has shown that hypopituitarism can occur along with traumatic brain injury. Many neurologists today treating traumatic brain injury automatically do blood tests to see if there is damage to the hypothalamus and/or pituitary gland. If this is the case then a referral to an endocrinologist is important because of hormone production deficiency.


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