Hypopituitarism following head injury--a case report.

A 16 year-old boy sustained fracture of the floor of the right orbital fossa in a road traffic accident with resultant diplopia and right enophthalmos. Symptoms of hypocortisolism subsequently developed. About two years after the trauma, pubertal changes which had occurred at 13-14 years had completely regressed. Endocrine testings confirmed clinical anterior hypopituitarism. Post-traumatic hypopituitarism may follow injury to the hypothalamus, the pituitary stalk or the pituitary itself. The normal thyroid stimulating hormone (TSH) response to thyrotropin releasing hormone (TRH) in this patient is in favour of a hypothalamic lesion. The patient has responded to replacement hormonal therapy.