Precocious Puberty Following Severe Head Trauma

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.