title: Resumption of luteinizing hormone pulsatility and hypogonadotropic hypogonadism after endoscopic ventriculocisternostomy in a hydrocephalic patient.
abstract: 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.
authors.affiliation: Department of Endocrinology and Reproductive Medicine, Hôpital Necker, and INSERM-AP-HP, Paris Cedex 15, 75743, France. philippe.touraine@nck.ap-hop-paris.fr
authors.forename: P
authors.initials: P
authors.lastname: Touraine
authors.forename: G
authors.initials: G
authors.lastname: Plu-Bureau
authors.forename: N
authors.initials: N
authors.lastname: Beressi
authors.forename: P
authors.initials: P
authors.lastname: Decq
authors.forename: J C
authors.initials: JC
authors.lastname: Thalabard
authors.forename: F
authors.initials: F
authors.lastname: Kuttenn
mesh_terms: 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
chemical_list: D007987:Gonadotropin-Releasing Hormone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone