Adrenocorticotropic hormone (ACTH) deficit comes in second with 6%, followed by LH/FSH deficiency with 5% and TSH deficiency with 1% (60).Notably, TBI severity assessed by the Glasgow Coma Scale (GCS) was poorly associated with the risk of hypopituitarism, suggesting that initial clinical symptoms are unreliable predictors of long-term endocrine sequelae (61).The pathophysiology of pituitary insufficiency after traumatic brain injury is thought to be multifaceted, ranging from primary mechanical injury to complex secondary insults. Here, POMC is linked to hypopituitarism.