Pituitary dysfunction after traumatic brain injury: screening and hormone replacement.

This article highlights the risk of hypopituitarism in survivors of traumatic brain injury (TBI), an underdiagnosed clinical problem. Clinical evidence shows that anterior pituitary dysfunction is common in TBI survivors evaluated at least 6 months after the TBI, with an estimated prevalence of up to 27.5%. Although patients who suffer from moderate-to-severe TBI appear to be at higher risk, the emerging data suggest that mild-intensity trauma can also precede hypopituitarism. Since many of the symptoms of hypopituitarism are similar to those of TBI, it is important for clinicians to be aware of this clinical problem. Moreover, we will address questions such as when to screen and who should be screened, along with a discussion of current management of pituitary dysfunction in patients with TBI.