Q: 28 year old patient is admitted to ICU after traumatic brain injury. While evaluating films with radiologist he shows concerns of ischemia to pituitary gland, hypothalamus and surrounding structures. Which treatments you need to be worried if symptoms of Panhypopituitarism develops?


Answer: Pituitary hormones of clinical significance include

• adrenocorticotropic hormone (ACTH),
• follicle-stimulating hormone (FSH),
• luteinizing hormone (LH),
• growth hormone (GH),
• prolactin,
• thyroid-stimulating hormone (TSH), and
• antidiuretic hormone (ADH)

4 essential treatments to keep in mind:

1. Desmopressin acetate (DDAVP) if Diabetes insipidus develops.
2. Hydrocortisone: Should be initiated even before workup is initiated.
3. Levo-thyroxine
4. Reproductive hormones (Estrogen or Testosterone)

Growth hormone is not routinely replaced in adults.