Pituitary imaging abnormalities in patients with and without hypopituitarism after traumatic brain injury
Harald J. Schneider1, Chiara G. Croce2, Ginevra Corneli2, Ezio Ghigo2, Günter K. Stalla1 & Gianluca Aimaretti2
Recent evidence shows that patients with traumatic brain injury (TBI) are at substantial risk of hypopituitarism. However, the pathomechanisms are still not completely understood. Little is known about the association of morphological changes in the sella region with pituitary function in TBI. In this study, we assessed morphological abormalities of the sella region in patients with TBI and their relation to endocrine function.
We have studied MR or CT scans of 22 patients with TBI (17 men, 5 women, age [mean +/− SD] 43.5+/− 10.6 years). Of these, 15 patients had some degree of hypopituitarism.
We found abnormalities of the sella region in 80% of the patients with hypopituitarism and 29% of those without hypopituitarism (P=0.03). The most common abnormality was loss of volume or empty sella, followed by inhomogeneities, perfusion deficits, and lack of neurohypophyseal signal.
This is the first study to investigate the association of morphological alteration and pituitary function in TBI. Our results indicate that pituitary imaging abnormalities are more common in TBI patients with than without hypopituitarism. Possibly, necrosis and/or hemorrhage play a potential role in posttraumatic hypopituitarism.