Pituitary function and IGF-I levels following ischemic stroke.
BACKGROUND
Pituitary dysfunction is a known complication of traumatic brain injury and subarachnoidal hemorrhage but there are few data about pituitary dysfunction as a complication of ischemic stroke.


METHODS
We prospectively studied patients 66-274 days after an ischemic stroke, evaluating the prevalence of pituitary dysfunction (by combined releasing hormone testing: GHRH, CRH), stroke severity, outcome and incidence of anxiety and depression.


RESULTS
Thirty-two patients (82%) presented with some degree of pituitary dysfunction with predominantly impaired growth hormone response (79.5%) and secondary adrenal failure (14.6%). Abnormal anxiety and/or depression was found in 28.3 and 32.7% of the patients. NIHSS (National Institute of Health Stroke Scale) varied between 1 and 15. Improvement in neurological deficit (ΔNIHSS) correlated significantly with NIHSS at baseline (p < 0.001) but not with pituitary function.


CONCLUSIONS
Patients with ischemic stroke may suffer from pituitary dysfunction with predominantly impaired growth hormone response and secondary adrenal failure. We suggest that patients who suffer from stroke should undergo pituitary testing.
Department of Internal Medicine 1, Division of Endocrinology, Diabetes and Metabolism, Stroke Unit, J.W. Goethe University, Frankfurt/M., Germany. Sandra.Boehncke@kgu.de
Sandra
S
Boehncke
Hanns
H
Ackermann
Klaus
K
Badenhoop
Matthias
M
Sitzer
D000368:Aged; D001007:Anxiety / Q000097:blood / Q000209:etiology / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D002545:Brain Ischemia / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D003863:Depression / Q000097:blood / Q000209:etiology / Q000503:physiopathology; D004185:Disability Evaluation; D005260:Female; D005858:Germany; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010901:Pituitary Function Tests; D010902:Pituitary Gland / Q000378:metabolism / Q000503:physiopathology*; D011446:Prospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D013997:Time Factors
D015415:Biomarkers; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I