CASE REPORT: Triphasic response of pituitary stalk injury following TBI: a relevant yet uncommonly recognised endocrine phenomenon

Goel, Ansha
Farhat, Freba
Zik, Chad
Jeffery, Michelle

¹Department of Medicine, Inova Health System, Falls Church, Virginia, USA,

Correspondence to Dr Ansha Goel, e-mail; [email protected]

/Accepted October 2, 2018

Contributors AG, FF, CZ and MJ all have made individual contributions to the writing of this article. We each have been involved in drafting the article for important intellectual content and final approval of the version published. We each agree to be accountable for the article and to ensure that all questions regarding the accuracy or integrity of the article are investigated and resolved.

Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

Competing interests None declared.

Patient consent Obtained.

Provenance and peer review Not commissioned; externally peer reviewed.

BMJ Case Reports :p 226725, January 2018. | DOI: 10.1136/bcr-2018-226725

The triphasic response of pituitary stalk injury has previously been described in a minority of patients following intracranial surgery, however, this phenomenon can also occur after traumatic brain injury. We present the case of a 20-year-old male who experienced the triphasic response of pituitary stalk injury (central diabetes insipidus, syndrome of inappropriate antidiuretic hormone and central diabetes insipidus again) after striking his head on a concrete curb. His history and presentation highlight the importance of recognising the distinctive symptoms of each individual stage of pituitary stalk injury, and using the appropriate diagnostic tools and therapies to guide further management.