Long-term pituitary function and functional and patient-reported outcomes in severe acquired brain injury.

This article focuses on the prevalence and impact of long-term hypothalamic–pituitary insufficiency in patients with severe acquired brain injury, comparing traumatic brain injury (TBI) and nontraumatic brain injury (NTBI). In a prospective study of 60 patients undergoing specialized neurorehabilitation, 28% exhibited hypopituitarism approximately 2.4 years post-injury, with similar rates in TBI (24%) and NTBI (39%) groups; deficiencies were mostly isolated and predominantly affected the gonadal axis. Importantly, pituitary insufficiency showed no significant association with functional outcomes measured by the Functional Independence Measure and Glasgow Outcome Scale-Extended at one year, nor with patient-reported quality of life or fatigue scores at follow-up. The findings suggest that while hypothalamic–pituitary dysfunction is relatively common after severe brain injury, its clinical relevance to functional recovery and patient experience remains unclear, indicating a need for larger, long-term studies to evaluate potential benefits of hormonal replacement therapy.