Currently, pituitary function is rarely considered in the care of patients with traumatic brain injury (TBI). Yet, TBI poses significant risk to pituitary (hormone) function given the gland’s encasement within the sella at the base of the brain, its delicate structures and vulnerable vascular supply. Autopsy studies of fatal head injury victims confirm that up to one third sustain pituitary injury and hundreds of case reports document chronic post-traumatic pituitary failure. The long-term neurobehavioral problems that plague a majority of moderate and severe TBI victims are quite similar to those of patients with pituitary failure. It is the primary hypothesis of this study that many TBI victims suffer from unrecognized pituitary dysfunction that acutely and chronically compounds the initial brain injury and limits maximal recovery.

Hence, it is proposed that acute secondary adrenal insufficiency is an important, but largely unstudied contributing factor that directly hinders recovery for many TBI victims. The specific aims of the study define the incidence, duration, pathogenesis, as well as the acute and chronic impact of steroid therapy in individuals with Acute Secondary Adrenal Insufficiency (ASAI).