Traumatic hypopituitarism: anterior hypophyseal insufficiency from indirect cranial trauma.

We have reported a case of partial hypopituitarism involving deficient ACTH, LH, FSH, and growth hormone production and elevated prolactin. The hypopituitarism was caused by injury to the pituitary resulting from a parachute accident without direct craniocerebral trauma. The pathogenesis of this pituitary injury as either a clivus fracture near the sella, unilated abstruction of the internal carotid artery, and/or direct stalk injury. Clinicians should be alerted to the possibility of hypopituitarism from direct or indirect cranial injuries.