title: Long-Term Follow-Up of Anterior Pituitary Deficiency after Aneurysmal Subarachnoid Hemorrhage: Prospective Cohort.
abstract: OBJECTIVE
  The aim of this study was to evaluate the prevalence of hypopituitarism in the acute stage after aneurysmal subarachnoid hemorrhage (SAH) as well at the chronic stage, at least 1 year after bleeding, to assess its implications and correlation with clinical features of the studied population.
  
  
  METHODS
  This was a prospective cohort study that evaluated patients admitted between December 2009 and May 2011 with a diagnosis of SAH secondary to cerebral aneurysm rupture. Clinical and endocrine assessment was performed during the acute stage after hospital admission and before treatment at a mean of 7.5 days (SD ± 3.8) following SAH, and also at the follow-up visit at a mean of 25.5 months (range: 12-55 months) after the bleeding.
  
  
  RESULTS
  Out of the 119 patients initially assessed, 92 were enrolled for acute stage, 82 underwent hormonal levels analysis, and 68 (82.9%) were followed up in both acute and chronic phases. The mean age and median age were lower among patients with dysfunction in the acute phase compared to those without dysfunction (P < .05). The prevalence of dysfunction in the acute phase was higher among patients with hydrocephalus on admission computed tomography (57.9%) than among those without it (P < .05). At chronic phase, there was an association between dysfunction and Hunt & Hess scale score greater than 2 (P < .05).
  
  
  CONCLUSIONS
  We believe that there is not enough literature evidence to incorporate routine endocrinological evaluation for patient victims of SAH, but we should always keep this differential diagnosis in mind when conducting long-term assessments of this population.
authors.affiliation: Department of Neurosurgery, Santa Casa Hospital, Belo Horizonte, Minas Gerais, Brazil; Faculty of Medicine, Department of Neurosurgery, Federal University of Minas Gerais-UFMG, Belo Horizonte, Minas Gerais, Brazil. Electronic address: vieiragjr@gmail.com.
authors.forename: Gerival
authors.initials: G
authors.lastname: Vieira
authors.affiliation: Department of Neurosurgery, Santa Casa Hospital, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Lucas Alverne Freitas
authors.initials: LA
authors.lastname: de Albuquerque
authors.affiliation: Department of Neurosurgery, Santa Casa Hospital, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Ariane Bernardes Camilo Castilho
authors.initials: AB
authors.lastname: de Avellar
authors.affiliation: Department of Neurosurgery, Santa Casa Hospital, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Julio Leonardo Barbosa
authors.initials: JL
authors.lastname: Pereira
authors.affiliation: Department of Neurosurgery, Santa Casa Hospital, Belo Horizonte, Minas Gerais, Brazil; Faculty of Medical Sciences of Minas Gerais-FCMMG, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Marcos
authors.initials: M
authors.lastname: Dellaretti
authors.affiliation: Department of Endocrinology, Santa Casa Hospital, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Paulo Augusto Carvalho
authors.initials: PA
authors.lastname: Miranda
authors.affiliation: Faculty of Medical Sciences of Minas Gerais-FCMMG, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Rodrigo Alvares Paiva
authors.initials: RA
authors.lastname: Macedo
authors.affiliation: Faculty of Medical Sciences of Minas Gerais-FCMMG, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Laura Amaral Quintino
authors.initials: LA
authors.lastname: da Silva
authors.affiliation: Faculty of Medicine, Department of Neurosurgery, Federal University of Minas Gerais-UFMG, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Sebastião Nataniel Silva
authors.initials: SN
authors.lastname: Gusmão
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000628:therapy; D015901:Angiography, Digital Subtraction; D001938:Brazil / Q000453:epidemiology; D002533:Cerebral Angiography / Q000379:methods; D000072226:Computed Tomography Angiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007018:Hypopituitarism / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D015994:Incidence; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010901:Pituitary Function Tests; D010903:Pituitary Gland, Anterior / Q000503:physiopathology*; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Subarachnoid hemorrhage; hypopituitarism; intracranial aneurysms; pituitary anterior lobe