Endocrine Abstracts

Traumatic Brain Injury (TBI) is a devastating neurological emergency, usually resulting in transient or permanent neurological dysfunction. It is the most common cause of death and disability in young adults in industrialised countries and is a major public health problem. Although anatomical pituitary damage following TBI was first recognised as long ago as 1918, evidence of hormonal dysfunction in both the acute and chronic phases following TBI had only been studied in detail over the last twenty years. There is now a rapidly growing evidence base showing that TBI may lead to both acute and long-term anterior and posterior pituitary dysfunction. However, it is often difficult to define what constitutes anterior pituitary damage in the acute period following TBI, as opposed to the acute adaptive hormonal changes which occur in most critically ill patients. Furthermore, given the huge numbers of patients who sustain a TBI, it is not possible to perform dynamic testing to screen for the presence of long-term hypopituitarism in all survivors of TBI. This talk aims to summarise the evidence base on the incidence of both acute and long term anterior and posterior pituitary dysfunction following TBI, and outline a pragmatic strategy to identify those who are most likely to benefit from dynamic pituitary testing.