POSTTRAUMATIC SELECTIVE HYPOGONADOTROPIC HYPOGONADISM

A very small proportion of hypopituitarism is due to head trauma, whic h may have occurred from days to years earlier. In the literature we f ound only three cases (two males, one female) of post-traumatic hypopi tuitarism in whom the hormone deficiency was claimed to be restricted to the gonadotrophs and considered to be permanent after a period of f ollow-up ranging from less than one year to four years. Here we descri be a 26 yr-old male patient who, eight years after a motorcycle accide nt, was evaluated for hypogonadism and followed-up for three years. Se rum testosterone, basal and GnRH-stimulated FSH and LH remained undete ctable over the first 22 months of follow-up. Then, basal and GnRH-sti mulated gonadotropins moved progressively into the normal range. Basal and dynamic evaluation of the other anterior pituitary hormones was p ersistently normal. At the 15th month of follow-up there was a change in the pituitary CT scan, presumably due to pituitary revascularizatio n. Therefore, our patient disproves that post-traumatic isolated gonad otropin deficiency is irreversible. (C) 1997, Editrice Kurtis.