Sports-related Chronic Repetitive Head Trauma as a Cause of Pituitary Dysfunction

Julie Dubourg, M.D.; Mahmoud Messerer, M.D.

Disclosures

Neurosurg Focus. 2011;31(5):e2 

In This Article

Abstract and Introduction

Abstract

Traumatic brain injury (TBI) is recognized as a cause of hypopituitarism even after mild TBI. Although over the past decade, a growing body of research has detailed neuroendocrine changes induced by TBI, the mechanisms and risk factors responsible for this pituitary dysfunction are still unclear. Around the world, sports—especially combative sports—are very popular. However, sports are not generally considered as a cause of TBI in most epidemiological studies, and the link between sports-related head trauma and hypopituitarism has not been investigated until recently. Thus, there is a paucity of data regarding this important concern. Because of the large number of young sports participants with near-normal life expectancy, the implications of undiagnosed or untreated postconcussion pituitary dysfunction can be dramatic. Understanding the pathophysiological mechanisms and risk factors of hypopituitarism caused by sports injuries is thus an important issue that concerns both medical staff and sponsors of sports. The aim of this paper was to summarize the best evidence for understanding the pathophysiological mechanisms and to discuss the current data and recommendations on sports-related head trauma as a cause of hypopituitarism.

Introduction

In today's realm of competitive sports environments worldwide, a large number of athletes participate in a wide variety of amateur or professional sports. Closed head injury is an occupational hazard of many sports, such as boxing, kickboxing, ice hockey, football, and many others. Participants in these sports are at risk for concussion, which is considered a type of mild TBI.

During the past decade, numerous studies have shown that TBI is often responsible for pituitary dysfunction such as hypopituitarism,[2,29,55] which seems to be readily present even after mild TBI. Although sports are a well-known cause of concussion, trauma due to sports is generally not considered to be a cause of TBI in most epidemiological studies. Thus, the link between sports-related head trauma and pituitary dysfunction is not well understood, even now. Recent studies have demonstrated that sports-related repetitive head trauma might induce pituitary dysfunction, and in particular, isolated GH deficiency.[38,65,67]

The aim of this paper was to summarize the best evidence for understanding the pathophysiological mechanisms and to discuss current data and recommendations on sports-related repetitive head trauma as a cause of hypopituitarism.

Comments

3090D553-9492-4563-8681-AD288FA52ACE

processing....