Evaluation of the anterior pituitary function in the acute phase after spontaneous subarachnoid hemorrhage.
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.


OBJECTIVE
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
56.9% of the patients showed at least one anterior pituitary hormone deficiency: gonadotropin and GH secretion failure represented the most prevalent hormonal deficiencies (33.3 and 22.0%, respectively), whereas ACTH and TSH deficiency was less frequent (7.1 and 1.8%, 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 Hunt-Hess 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 follow-up.
Parenti
G
G
Endocrine Unit, Department of Clinical Physiopathology, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy.
Cecchi
P C
PC
Ragghianti
B
B
Schwarz
A
A
Ammannati
F
F
Mennonna
P
P
Di Rita
A
A
Gallina
P
P
Di Lorenzo
N
N
Innocenti
P
P
Forti
G
G
Peri
A
A
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007018:Hypopituitarism / Q000097:blood / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010903:Pituitary Gland, Anterior / Q000502:physiology* / Q000503:physiopathology*; D010907:Pituitary Hormones / Q000097:blood / Q000172:deficiency; D013345:Subarachnoid Hemorrhage / Q000150:complications / Q000503:physiopathology*; D013963:Thyroid Hormones / Q000097:blood / Q000172:deficiency
D010907:Pituitary Hormones; D013963:Thyroid Hormones
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