Authors: G Parenti P C Cecchi B Ragghianti A Schwarz F Ammannati P Mennonna A Di Rita P Gallina N Di Lorenzo P Innocenti G Forti Alessandro Peri
Publish Date: 2010/08/31
Volume: 34, Issue: 5, Pages: 361-365
Abstract
Background Subarachnoid hemorrhage SAH is a potential cause of hypopituitarism Most of the studies regarding the relationship between SAH and anterior pituitary function were retrospective and hormonal assessment was performed several months after SAH Aim To prospectively evaluate the prevalence of anterior pituitary hormone deficiencies in the acute phase after spontaneous SAH and their possible correlation with clinical and radiological parameters Methods Pituitary function was tested in 60 patients within 72 h after spontaneous SAH Results 569 of the patients showed at least one anterior pituitary hormone deficiency gonadotropin and GH secretion failure represented the most prevalent hormonal deficiencies 333 and 220 respectively whereas ACTH and TSH deficiency was less frequent 71 and 18 respectively With the exception of secondary hypogonadism the prevalence of other pituitary hormone deficiencies is in agreement with previous studies which evaluated pituitary function on longterm follow up after SAH No correlation was found between hypopituitarism and clinical status as assessed with HuntHess and Glascow Coma Scales Moreover no correlation was found between hypopituitarism and bleeding severity evaluated with Fisher’s scale Conclusions We demonstrated a high prevalence of anterior pituitary hormone deficiencies acutely after SAH Although part of GH and gonadotropin deficiencies might be a consequence of functional alteration due to SAH itself the finding of low cortisol levels in this stressful condition strongly suggests the presence of true hypocortisolism Therefore an evaluation of pituitary function shortly after SAH might be useful to identify a subset of patients who deserve a more accurate followup
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