Precocious puberty following severe head trauma
P. W. Shaul, R. B. Towbin and S. D. Chernausek
True precocious puberty is frequently secondary to intrinsic central
nervous system pathology, but is rare following external head trauma. We
describe two children who developed precocious puberty within three months
of severe exogenous head trauma. Infusion of luteinizing hormone releasing
factor induced a prompt rise in circulating gonadotropin concentrations and
established that their sexual precocity was the result of premature
activation of the hypothalamic-pituitary axis. While the precise mechanism
by which exogenous head trauma causes precocious puberty remains unknown,
the clinical features of these children's disorders are consistent with the
hypothesis that extra-hypothalamic areas restrain pituitary gonadotropin
secretion before puberty and that damage to these areas can result in
precocious puberty.