Precocious puberty in a girl following severe traumatic brain injury (Tbi) in early childhood: A simple coincidence or a possible consequence?

Abstract

True precocious puberty (PP) is rare following external head trauma. We describe the long term follow-up of a girl who developed PP at the age of 7.6 years, after three years of severe head trauma. Severe brain injury may be associated with hypothalamic-pituitary dysfunction including PP; however, the mechanism is not yet wellunderstood. The current case report highlights the importance of close monitoring of patients following significant head trauma. Children exhibiting signs of early puberty need prompt evaluation by the appropriate Paediatric medical subspecialist. The diagnosis should include detailed anamnesis and clinical examination, measurement of pituitary and sex hormones, assessment of bone age and imaging of the hypothalamic-pituitary area and gonads. Therapy with a gonadotropin-releasing hormone agonist (GnRH) may be indicated, in selected cases.