Fatigue after aneurysmal subarachnoid hemorrhage evaluated by pituitary function and 3D-CBF.
OBJECTIVE
The reason for longstanding fatigue following aneurysmal subarachnoidal hemorrhage (SAH) is still not clarified. The bleed from supratentorial aneurysms is often in the vicinity of the hypothalamus and pituitary gland making an endocrine dysfunction plausible.


METHODS
Ten patients with post-SAH fatigue were investigated with 3D-CBF (SPECT) and underwent an evaluation of the pituitary function.


RESULTS
Five had normal pituitary function. Disturbances in the gonadotropin function was detected in three patients and suspected in two. The mean insulin-like growth factor I (IGF-I) value of the patients was in the lower part of the reference range. In the patients with endocrine dysfunction, the 3D-CBF was pathologic in the central structures of the basal region.


CONCLUSIONS
The present results indicate that an aneurysmal SAH may result in partially impaired pituitary capacity. This deficit may contribute to fatigue after aneurysmal SAH, but cannot solely explain this disorder. SPECT identified regional tissue damage in the patients with pituitary dysfunction after SAH.
Brandt
L
L
Department of Neurosurgery, University Hospital of Lund, Lund, Sweden. lennart.brandt@neurokir.lu.se
Säveland
H
H
Valdemarsson
S
S
Sjöholm
H
H
Reinstrup
P
P
D000328:Adult; D005221:Fatigue / Q000209:etiology*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008297:Male; D008875:Middle Aged; D010902:Pituitary Gland / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology*; D012039:Regional Blood Flow; D013345:Subarachnoid Hemorrhage / Q000150:complications*; D015899:Tomography, Emission-Computed, Single-Photon
D007334:Insulin-Like Growth Factor I