Risk of pituitary-related depression following head injury

Head injuries can often cause damage to the pituitary gland leading to hormonal problems. Here, Caroline Churchill gives her account of her son’s head injury as a child, and the problems he suffered as an adult including sexual dysfunction and depression, leading eventually to suicide. Brain injury is already recognized as quadrupling suicide risk, and Caroline believes that her son’s childhood accident could have been the cause of his problems.

Have you seen a similar case? There are particularly few cases in the literature  of hormonal problems after head trauma in childhood, and we welcome submission of any case reports of this type. As pituitary damage can happen in 1 in 4 head injuries, there must be a lot of cases out there that others can learn from.

Caroline writes:

“Our 31-year-old son committed suicide last August. At first we were baffled because he excelled at his job and had many friends. But we discovered letters between him and his ex-girlfriend showing he was impotent, which she later confirmed applied to all their four years together. We wondered if this could stem from a terrible head injury (right temporal fracture) he’d had aged seven, when he’d fallen from a tree, been in a coma for five days and hospitalised for a month. We then found abundant research from 1998 on, showing that 25% of moderate/severe head injuries cause pituitary damage. The effects include growth hormone deficiency, loss of libido, amenorrhoea in women, ED in men, infertility and depression. Particularly revealing was Acerini’s Childhood Hypopituitarism after Traumatic Brain Injury that showed childhood injuries too can cause hypopituitarism, the onset sometimes coming many years after injury. This explained how our son could have grown tall, had a normal adolescence, and yet been affected.

We were surprised that something so well documented hadn’t filtered through to medical practice. In 1984 when his accident happened, the research did not exist so obviously we weren’t warned, but later the signs were there, if someone could have read them. The following time-line comes partly from our knowledge, partly from his medical notes:

  • Disappeared before A-levels
  • Depressed in final year at university (failed to take degree)
  • Depressed in November 1999
  • Disappeared for 2 weeks in 2003, year after girlfriend left. Returned saying had attempted suicide. Tried cross-dressing before disappearance, visited transvestite chat-room.
  • September 2003, saw a GP, psychiatrist and counsellor, nobody picked up on past head injury or suggested pituitary screening. Apparent recovery.
  • February 2007 saw GP re headaches, mum fearing tumour from brain injury. Tests negative, but again no pituitary screening. GP observed proptosis in right eye but thyroid tests normal.
  • (Also early 2007 ex-girlfriend asked him to test for chlamydia, perhaps worried re heavy petting, but test negative. GP notes say genitalia normal, our son ‘not currently sexually active.’)
  • Five weeks before suicide, told manager he was depressed, she fixed counselling. Had five sessions before gassing himself with helium. Bank statements show he’d planned this for seven weeks.

We’re amazed that the 2007 NICE guideline on head injury does not advise pituitary screening, and their sample discharge letter does not mention the risk. If hypopituitarism can occur years later, warning people is vital.”

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3 Responses to “Risk of pituitary-related depression following head injury”

  1. Rashid Says:

    I fell down from a one story building and rolled down another story on cement steps at age 7. I am 55 years old now and have a normal growth but since childhood had sexual problems. I have very small testicals and even now my Hormone level is 224. I have read taht Childhood head injury can cause problems with initiating & controlling sexual maturation during childhood puberty and later in life. It can also cause deficiency of Gonadotropins( Follicle stimulating harmone and Luteinizing hormone.
    Appreciate a response

    • casesnetwork Says:

      Thank you for your comment on this perhaps under-recognised problem. Cases Network does not give out medical advice, nor do we recommend any advice taken from our case reports. However, we would certainly recommend that you approach your doctor and suggest that they submit a case report regarding your experiences. We always strongly encourage authors to invite their patients to contribute to case reports by including an account of the case in the patient’s own words: the ‘Patient’s perspective’. Your own description of your experience may help other patients or doctors who are dealing with a similar problem. By contributing to a case report you are eligible to be named as an author, but if you would prefer to remain anonymous this is also perfectly acceptable.

  2. Phil Young Says:

    Hi, I had a head injury in 1998 but brain damage wasn’t diagnosed until 2004 and I thought that I was going mad as nobody would listen to me or my symptoms. I am still battling day to day with the symptoms. Someone gave me Carolines article about Hypopituitarism a week ago. Until then I had never heard of it even though my accident was 11.5 years ago ! I had blood tests the other day and am waiting for the results. I am trying not to get my hopes up too much and am aware that the symptoms for Hypopituitarism are very similar to those of brain damage itself and subsequent depression. I hope that the blood tests confirm that something can be done to help me. Thank You so very much.

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