Traumatic brain injury (TBI) is a major public health problem with potentially debilitating consequences for the individual. Hypopituitarism after TBI has received increasing attention over the past decade; development of the condition as a consequence of TBI was previously hardly mentioned in textbooks on the subject. Hypopituitarism has been reported in more than 25% of patients with TBI and is now thought to be one of the most important causes of treatable morbidity in TBI survivors. However, most clinicians dealing with neuroendocrine diseases and TBI generally do not see such a high incidence of hypopituitarism. This disproportion is not clearly explained, but recent data indicate that diagnostic testing, which is designed for high-risk populations and not for a cohort of patients with, for example, de novo isolated growth hormone deficiency (the predominant finding in TBI), might have overestimated the true risk and disease burden of hypopituitarism. In this Opinion article, we discuss current recommendations for post-traumatic hypopituitarism in light of recent evidence.

颅脑外伤（TBI）是主要的公共健康问题，对个人可能造成破坏性后果。TBI后的垂体功能减退在过去十年中受到越来越多的关注。先前在有关该主题的教科书中几乎没有提及由于TBI导致的疾病发展。垂体功能减退症在25％的TBI患者中已有报道，现在被认为是TBI幸存者可治愈的最重要的病因之一。但是，大多数处理神经内分泌疾病和TBI的临床医生通常都没有看到垂体功能低下的高发生率。这种歧义并没有得到清楚的解释，但是最近的数据表明诊断测试是为高风险人群设计的，而不是针对从头开始的患者孤立的生长激素缺乏症（在TBI中的主要发现）可能高估了垂体机能减退的真正风险和疾病负担。在这篇观点文章中，我们根据最新证据讨论了创伤后垂体功能低下的最新建议。