Post-traumatic hypopituitarism due to a hypothalamic lesion.

Two patients were studied who suffered from severe head trauma with skull fracture. Hypopituitarism developed in both. Because of elevated serum prolactin levels and because of preserved response of some of the pituitary hormones to exogenous thyrotropin and gonadotropin-releasing hormones, the responsible lesion in both cases was most likely suprasellar. Findings of interest included slightly elevated thyroid-stimulating hormone (TSH) levels in the presence of hypothyroidism in one of the patients, and dissociation of the luteinizing hormone (LH) and follicle-stimulating hormone (FSH) responsiveness to both gonadotropin-releasing hormone and clomiphene citrate in the other patient. It is suggested that the diagnosis of post-traumatic hypopituitarism be considered in patients with head trauma and that periodically appropriate laboratory testing be performed to confirm the diagnosis.