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Pituitary dysfunction after aneurysmal subarachnoid hemorrhage is associated with impaired early outcome.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Kronvall, Erik Valdemarsson, Stig Säveland, Hans Nilsson, Ola G.
Description	Author Affiliation: Kronvall E ( Department of Neurosurgery, Lund University, Skåne University Hospital, Lund, Sweden. Electronic address: erik.kronvall@med.lu.se.); Valdemarsson S ( Department of Oncology, Lund University, Skåne University Hospital, Lund, Sweden.); Säveland H ( Department of Neurosurgery, Lund University, Skåne University Hospital, Lund, Sweden.); Nilsson OG ( Department of Neurosurgery, Lund University, Skåne University Hospital, Lund, Sweden.)
Abstract	OBJECTIVE: Poor outcome and neuropsychological sequelae after aneurysmal subarachnoid hemorrhage (SAH) is a persistent problem. Pituitary dysfunction has been proposed as a contributing factor. Clinical studies have given variable and conflicting results on its importance and incidence after SAH. The aim of this study was to prospectively examine SAH patients with assessment of endocrine function in the acute stage and at early follow-up and to compare clinical SAH features to endocrine abnormalities indicating pituitary dysfunction. METHODS: Endocrine function was assessed by basal hormonal concentrations at 5 to 10 days and 3 to 6 months after SAH. Growth hormone deficiency also was evaluated by the growth hormone releasing hormone-arginine stimulation test at follow-up. Clinical outcome was assessed and scored according to the Glasgow Outcome Scale. RESULTS: Fifty-one SAH patients were included and assessed in the acute stage after the bleed. Six were lost to follow-up. The overall prevalence of pituitary dysfunction was 37% and 27% in the acute stage and at follow-up, respectively. Patients with evidence of pituitary dysfunction had significantly worse outcome according to Glasgow Outcome Scale at both occasions. The ruptured aneurysm was more commonly located in the circle of Willis among patients with pituitary dysfunction in the acute stage. CONCLUSIONS: The present results support earlier findings that hormonal abnormalities are not infrequent after SAH. Furthermore, our data suggest that pituitary dysfunction is associated with worse clinical outcome and is more common among patients with bleeding sites close to the hypothalamus.
File Format	HTM / HTML
ISSN	18788750
Issue Number	3-4
Volume Number	81
e-ISSN	18788769
Journal	World Neurosurgery
Language	English
Publisher	Elsevier
Publisher Date	2014-03-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Neurosurgery Aneurysm, Ruptured Epidemiology Surgery Hypopituitarism Subarachnoid Hemorrhage Acute Disease Adult Aged Aged, 80 And Over Female Follow-up Studies Glasgow Coma Scale Hormones Blood Humans Incidence Male Middle Aged Prevalence Prospective Studies Treatment Outcome Young Adult Journal Article
Content Type	Text
Resource Type	Article
Subject	Neurology (clinical) Surgery

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