Traumatic brain injury and hypopituitarism in children and adolescents: is the problem under-estimated?

Traumatic brain injury (TBI) is the leading cause of death in children. Only recently, the importance of hypopituitarism as a consequence of TBI has been highlighted in adult patients. Data from systematic clinical studies in adults and patients in transition from adolescence to adulthood point to the presence of hypopituitarism in nearly a third of patients hospitalized for TBI. But, no systematic studies on posttraumatic hypopituitarism exist in children and adolescents. Case reports and small series of patients, however, suggest that children are affected to a comparable extent. Since normal pituitary function is required for normal growth and pubertal development in childhood, particular attention should be paid to this condition. The aim of this review is to summarize the literature on TBI and causes, clinical picture, and diagnosis of hypopituitarism in childhood and adolescence, underlying the relevance of the problem and its underestimation in clinical paediatric practice.