title: Pituitary dysfunction after aneurysmal subarachnoid hemorrhage in Japanese patients.
abstract: To elucidate the pituitary function of Japanese patients after aneurysmal subarachnoid hemorrhage (aSAH) and implicative factors related to growth hormone deficiency (GHD) after aSAH. We evaluated basal pituitary hormone levels among 59 consecutive aSAH patients with a modified Rankin Scale (mRS) ⩽4 at 3months after aSAH onset. Patients with low insulin-like growth factor 1 (IGF-1) SD score (SDS) or who seemed to develop pituitary dysfunction underwent provocative endocrine testing during a period of 3-36months after SAH onset. The relationship between IGF-1 SDS and clinical factors of the patients such as severity of SAH, aneurysm location, and treatment modalities, were assessed. Six patients (10.2%) demonstrated their IGF-1 SDS less than -2. Multiple logistic regression analyses revealed that patients who underwent surgical clipping had a significantly lower IGF-1 SDS (<-1SD) than patients who underwent endovascular embolization with an odds ratio of 5.83 (p=0.032). Thirty-three patients took provocative tests and five (15.6%) patients were identified as having GHD. The mean IGF-1 SDS of these five GHD patients was 0.08 SD. The aneurysms in all GHD patients were located in internal carotid artery (ICA) or anterior cerebral artery (ACA). To the best of our knowledge, this is the first report describing the prevalence of GHD in Japanese patients after aSAH, and it was not as high as that of previous European studies. We recommend that screening pituitary dysfunction for aSAH survivors with their aneurysms located in ICA or ACA.
authors: Department of Neuromodulation and Neurosurgery, Graduate School of Medicine, Osaka University, 2-2, Yamadaoka, Suita, Osaka Prefecture 565-0871, Japan; Department of Neurosurgery, Graduate School of Medicine, Osaka University, Osaka Prefecture, Japan.
authors: Yuko
authors: Y
authors: Goto
authors: Department of Neurosurgery, Graduate School of Medicine, Osaka University, Osaka Prefecture, Japan.
authors: Satoru
authors: S
authors: Oshino
authors: Department of Neurosurgery, Hanwa Memorial Hospital, Sumiyoshi Ward, Osaka, Osaka Prefecture, Japan.
authors: Akio
authors: A
authors: Nishino
authors: Department of Neurosurgery, National Hospital Organization Osaka National Hospital, Chuo Ward, Osaka, Osaka Prefecture, Japan.
authors: Toshiyuki
authors: T
authors: Fujinaka
authors: Department of Neurosurgery, Graduate School of Medicine, Osaka University, Osaka Prefecture, Japan.
authors: Hajime
authors: H
authors: Nakamura
authors: Yuguchi Neurosurgical and Spine Clinic, Tennoji Ward, Osaka, Osaka Prefecture, Japan.
authors: Takamichi
authors: T
authors: Yuguchi
authors: Department of Neurosurgery, Hanwa Memorial Hospital, Sumiyoshi Ward, Osaka, Osaka Prefecture, Japan.
authors: Shintaro
authors: S
authors: Mori
authors: Department of Neurosurgery, Graduate School of Medicine, Osaka University, Osaka Prefecture, Japan.
authors: Toshiki
authors: T
authors: Yoshimine
authors: Department of Neuromodulation and Neurosurgery, Graduate School of Medicine, Osaka University, 2-2, Yamadaoka, Suita, Osaka Prefecture 565-0871, Japan; Department of Neurosurgery, Graduate School of Medicine, Osaka University, Osaka Prefecture, Japan. Electronic address: neurosaitoh@mbk.nifty.com.
authors: Youichi
authors: Y
authors: Saitoh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020771:Anterior Cerebral Artery; D044466:Asian People; D002340:Carotid Artery Diseases / Q000150:complications; D002343:Carotid Artery, Internal; D004621:Embolization, Therapeutic; D005260:Female; D019382:Human Growth Hormone / Q000172:deficiency; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010900:Pituitary Diseases / Q000453:epidemiology / Q000209:etiology*; D010901:Pituitary Function Tests; D010907:Pituitary Hormones / Q000097:blood; D015995:Prevalence; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000628:therapy
chemical_list: D010907:Pituitary Hormones; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I
keywords: Aneurysmal subarachnoid hemorrhage; Endovascular embolization; Growth hormone deficiency; Pituitary dysfunction; Surgical clipping