Resumption of luteinizing hormone pulsatility and hypogonadotropic hypogonadism after endoscopic ventriculocisternostomy in a hydrocephalic patient.
OBJECTIVE
To study gonadotropin pulsatility before and after surgical cure of hydrocephalus.


METHODS
Case report.


METHODS
Department of Endocrinology and Centre d'Investigations Cliniques, Necker Hospital, Paris, France.


METHODS
A 29-year-old woman who presented with secondary amenorrhea.


METHODS
The patient underwent an endoscopic ventriculocisternostomy that led to restoration of normal menses and resolution of hypogonadism.


METHODS
A gonadotropin pulse study was performed before and 2 and 5 months after surgery.


RESULTS
No LH pulse was observed before surgery. Emergence of pulsatility was observed 2 months after surgery, and pulses became clearly individualized after 5 months.


CONCLUSIONS
This observation strongly suggests that amenorrhea, in case of chronic hydrocephalus, is indeed due to a hypothalamic dysfunction of the GnRH pulse generator.
Touraine
P
P
Department of Endocrinology and Reproductive Medicine, Hôpital Necker, and INSERM-AP-HP, Paris Cedex 15, 75743, France. philippe.touraine@nck.ap-hop-paris.fr
Plu-Bureau
G
G
Beressi
N
N
Decq
P
P
Thalabard
J C
JC
Kuttenn
F
F
D000328:Adult; D000568:Amenorrhea / Q000209:etiology / Q000628:therapy; D004724:Endoscopy; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D007987:Gonadotropin-Releasing Hormone / Q000502:physiology; D006801:Humans; D006849:Hydrocephalus / Q000150:complications / Q000601:surgery*; D007006:Hypogonadism / Q000209:etiology / Q000628:therapy*; D007986:Luteinizing Hormone / Q000097:blood*; D011673:Pulsatile Flow; D014696:Ventriculostomy
D007987:Gonadotropin-Releasing Hormone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone