title: The effect of hypopituitarism on fatigue after subarachnoid hemorrhage.
abstract: Aneurysmal subarachnoid hemorrhage (SAH) survivors often complain of fatigue, which is disabling. Fatigue is also a common symptom of pituitary dysfunction (PD), in particular in patients with growth hormone deficiency (GHD). A possible association between fatigue after SAH and long-term pituitary deficiency in SAH survivors has not yet been established.
  
  
  
  A single center observational study was conducted amongst 84 aneurysmal SAH survivors to study the relationship between PD and fatigue over time after SAH, using mixed model analysis. Fatigue was measured with the Fatigue Severity Scale and its relationships with other clinical variables were studied.
  
  
  
  Three-quarters of respondents (76%) have pathological fatigue directly after SAH and almost two-thirds (60%) of patients still have pathological levels of fatigue after 14 months. The severity of SAH measured with a World Federation of Neurosurgical Societies (WFNS) score higher than 1 (P = 0.008) was associated with long-term fatigue. There is no statistically significant effect of PD (P = 0.8) or GHD (P = 0.23) on fatigue in SAH survivors over time.
  
  
  
  Fatigue is a common symptom amongst SAH survivors. WFNS is a usable clinical determinant of fatigue in SAH survivors. Neither PD nor GHD has a significant effect on long-term fatigue after SAH.
authors.affiliation: Department of Neurology, Section Endocrinology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: L
authors.initials: L
authors.lastname: Khajeh
authors.affiliation: Department of Rehabilitation, Erasmus University Medical Center and Rijndam Rehabilitation Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: G M
authors.initials: GM
authors.lastname: Ribbers
authors.affiliation: Department of Rehabilitation, Erasmus University Medical Center and Rijndam Rehabilitation Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: M H
authors.initials: MH
authors.lastname: Heijenbrok-Kal
authors.affiliation: Department of Medicine, Section Endocrinology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: K
authors.initials: K
authors.lastname: Blijdorp
authors.affiliation: Department of Neurology, Section Endocrinology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: D W J
authors.initials: DW
authors.lastname: Dippel
authors.affiliation: Department of Rehabilitation, Erasmus University Medical Center and Rijndam Rehabilitation Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: E M
authors.initials: EM
authors.lastname: Sneekes
authors.affiliation: Department of Rehabilitation, Erasmus University Medical Center and Rijndam Rehabilitation Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: H J G
authors.initials: HJ
authors.lastname: van den Berg-Emons
authors.affiliation: Department of Medicine, Section Endocrinology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: A J
authors.initials: AJ
authors.lastname: van der Lely
authors.affiliation: Department of Medicine, Section Endocrinology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: S J C M M
authors.initials: SJ
authors.lastname: Neggers
authors.affiliation: Department of Neurology, Section Endocrinology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: F
authors.initials: F
authors.lastname: van Kooten
mesh_terms: D000328:Adult; D000368:Aged; D005221:Fatigue / Q000209:etiology*; D005260:Female; D006801:Humans; D007018:Hypopituitarism / Q000150:complications*; D008297:Male; D008875:Middle Aged; D013345:Subarachnoid Hemorrhage / Q000150:complications*; D017741:Survivors
keywords: fatigue; growth hormone deficiency; hypopituitarism; subarachnoid hemorrhage