New research shows the "master gland" is vulnerable to injury
While it's well understood in a general sense that brain injuries are serious and often catastrophic, new research is showing just how dangerous trauma to the head or brain can be. In particular, studies have shown a link between brain injuries such as concussions and damage to the pituitary gland.
The pituitary, often known as the "master gland," plays a vital role in the endocrine system, the portion of the body that produces and regulates hormones. Hormones produced by the pituitary manage growth, blood pressure, pain, metabolism, temperature, water balance and sexual function, among other vital bodily functions. As such, any injury that causes damage to the pituitary can have significant and permanent implications for the victim's quality of life.
That's why studies showing that between 30 and 50 percent of brain injuries may also involve pituitary damage are so concerning. Given that there are millions of brain injuries nationwide every year, hundreds of thousands of people may be suffering from symptoms of pituitary dysfunction - and many, if not most of those victims may not even know that anything is wrong.
The mechanism of injury: Whiplash inside the skull
Because the pituitary is such an important gland, it is well-protected against direct trauma. Specifically, it is placed inside a bony cavity in the base of the cranium called the "sulci" - Latin for "opening." A network of nerves and blood vessels connects the pituitary gland with the brain above.
However, the rest of the brain is not quite so well protected. When a person sustains a traumatic brain injury, whether from a fall, vehicle accident, sports injury or other cause, the brain moves violently forward and backward inside the skull while the pituitary remains in place. This forward and backward movement can stretch the blood vessels in the stalk that connects the pituitary gland with the brain, just like the violent forward and backward movement of the head can cause a whiplash injury in the neck. These injuries are particularly common in younger victims because the pituitary gland is typically more plump and has less room to maneuver, subjecting the stalk to more stretching, twisting or tearing.
The result is that the flow of blood to and from portions of the pituitary is compromised, which can cause necrosis, or dying of certain cells in the pituitary. This in turn reduces or compromises the pituitary's production of certain hormones.
Detecting and understanding pituitary damage is a complex process
The anatomy of the pituitary and the nature of the blood vessels makes certain types of damage more likely than others. For the most part, the most important portions of the gland are in the front and center of the pituitary, where they receive blood from the superior hypophyseal artery - the main blood vessel supplying blood to the pituitary - itself. Those portions are relatively insulated from damage, though they can become injured as well. However, the lateral "wings" of the pituitary receive their blood supply from smaller capillaries that can be easily torn. That's why the most common symptom of pituitary injury is a deficiency of growth hormone, which is produced in that vulnerable portion of the gland.
The very anatomy of the pituitary makes detecting this damage difficult. Although the name "artery" might imply that it is a large blood vessel, the superior hypophyseal artery is actually quite small, and the surrounding capillaries are even smaller. As a result, damage to these blood vessels is nearly impossible to detect on an MRI. Doctors normally need to conduct a blood test for hormonal deficiency to confirm the diagnosis.
Legal rights for victims of pituitary injury
In many, if not most cases, people who sustain brain injuries leading to pituitary damage are victims of the negligence of others. Vehicle accidents are a leading cause of brain injuries, as are falls - which are often the result of negligence on the part of a property owner. Likewise, there is often liability involved when a victim is assaulted or injured during a recreational activity. That means the best way to get fair compensation for the extensive medical costs, both past and future, from a pituitary injury may come via a lawsuit.
However, litigating cases based on pituitary damage is not easy, especially as this is still new research in the medical field. An attorney must have the knowledge to demonstrate that the pituitary has been injured, which requires a review of medical records, and show that the mechanism of injury was trauma to the head caused by the at-fault party's negligence. Moreover, the symptoms of hormonal deficiencies and imbalances are complex, and a thorough analysis is needed to determine the full cost of the injury. That is why victims of pituitary injury can benefit greatly from seeking experienced legal counsel.