title: Somatotropic and thyroid hormones in the acute phase of subarachnoid haemorrhage.
abstract: BACKGROUND
  Somatotropic and thyroid hormones are probably important for the recovery after acute brain injury. Still, the dynamics of these hormones after spontaneous subarachnoid haemorrhage (SAH) is not well described. The purpose of this study was to investigate the relation between somatotropic and thyroid hormones and clinical factors after SAH.
  
  
  METHODS
  Twenty patients with spontaneous SAH were included prospectively. Serum concentrations of TSH, fT4, T3, IGF-1 and GH were measured once a day for 7 days after SAH. Hormone patterns and serum concentrations were compared to the severity of SAH, neurological condition at admission, clinical course and outcome of the patients.
  
  
  RESULTS
  During the first week after SAH, all patients showed increased GH and IGF-1 concentrations. In the whole group, concentrations of TSH increased, whereas T3 and fT4 decreased. There were no relations of serum concentrations of IGF-1 or GH to clinical condition at admission, clinical course or outcome of the patients. Half of the patients showed low T3 serum concentrations. A complicated course was associated with a deeper fall in TSH and T3 concentrations. There were negative correlations for mean concentrations of TSH and T3 versus WFNS grade and a positive correlation for T3 versus GOS after 6 months, indicating that low concentrations of TSH and T3 were connected to worse SAH grade and poor outcome.
  
  
  CONCLUSIONS
  All patients showed increased GH and IGF-1 concentrations irrespective of the grade of SAH or clinical course. Patients with a complicated clinical course showed a more pronounced fall in TSH and T3 concentrations and low serum T3 concentrations were related to a more serious SAH and poor patient outcome. These results need to be studied further and they may contribute to the accumulated knowledge needed to understand the complex mechanisms influencing the unpredictable clinical course after SAH.
authors.affiliation: Department of Neuroscience, Neurosurgery, Uppsala University, Uppsala University Hospital, 751 85, Uppsala, Sweden, maria.zetterling@akademiska.se.
authors.forename: Maria
authors.initials: M
authors.lastname: Zetterling
authors.forename: Britt Edén
authors.initials: BE
authors.lastname: Engström
authors.forename: Steinunn
authors.initials: S
authors.lastname: Arnardottir
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Ronne-Engström
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000378:metabolism; D005260:Female; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013345:Subarachnoid Hemorrhage / Q000097:blood* / Q000378:metabolism; D013963:Thyroid Hormones / Q000097:blood*; D013997:Time Factors
chemical_list: D013963:Thyroid Hormones; D007334:Insulin-Like Growth Factor I