title: Acute hormonal findings after aneurysmal subarachnoid hemorrhage - report from a single center.
abstract: OBJECTIVE
  The aim was to assess anterior pituitary hormone levels during the acute phase of aneurysmal subarachnoid hemorrhage (aSAH) and analyze the possible association with the clinical condition and outcome.
  
  
  METHODS
  Forty patients with aSAH whose aneurysm was secured by endovascular coiling were enrolled. Basal secretions of cortisol, testosterone, luteinizing hormone (LH), prolactin (PRL), and sex hormone binding globulin (SHBG) levels were measured up to 14 days after the incident.
  
  
  RESULTS
  The main finding was that hypocortisolism was rare whereas testosterone deficiency was common in male patients. Furthermore, various other hormone deviations were frequent and there was wide interindividual variability. We found no association between delayed cerebral ischemia (DCI), outcome of the patients or aneurysm location, and hormone abnormalities, while both Hunt & Hess and Fisher grade were associated with low PRL levels. Hunt & Hess 5 was associated with low PRL concentration when compared to grades 1 (OR = 4.81, 95% CI 1.15-20.14, p = 0.03), 3 (OR 7.73, 95% CI 1.33-45.01, p = 0.02), and 4 (OR = 6.86 95% CI 1.28-26.83, p = 0.02). Fisher grade 4 was associated with low PRL concentration when compared to grades 3 (OR 3.37, 95% CI 1.06-10.73, p = 0.03) and 2 (OR 9.71, 95% CI 1.22-77.10, p = 0.04).
  
  
  CONCLUSIONS
  Deviations from normal and huge interindividual differences are common in hormone levels during the acute phase of aSAH. Routine assessment of anterior pituitary function in the acute phase of aSAH is not warranted. During the follow-up in the outpatient clinic, hormone concentrations were not measured, which would have brought a more long-term perspective into our findings.
authors.affiliation: a Perioperative Services, Intensive Care Medicine and Pain Management , Turku University Hospital and University of Turku , Turku , Finland.
authors.forename: Riikka S K
authors.initials: RS
authors.lastname: Takala
authors.affiliation: b Division of Internal Medicine, Department of Endocrinology , Turku University Hospital , Turku , Finland.|c Departments of Medicine and Medical Biochemistry and Genetics , University of Turku , Turku , Finland.
authors.forename: Riku
authors.initials: R
authors.lastname: Kiviranta
authors.affiliation: d Department of Anaesthesiology and Intensive Care Medicine , University of Helsinki and Helsinki University Hospital , Helsinki , Finland.
authors.forename: Klaus T
authors.initials: KT
authors.lastname: Olkkola
authors.affiliation: e Department of Clinical Medicine, Biostatistics , University of Turku, and Turku University Hospital , Turku , Finland.
authors.forename: Tero
authors.initials: T
authors.lastname: Vahlberg
authors.affiliation: f Division of Clinical Neurosciences, Department of Neurosurgery , Turku University Hospital and University of Turku , Turku , Finland.
authors.forename: Dan
authors.initials: D
authors.lastname: Laukka
authors.affiliation: f Division of Clinical Neurosciences, Department of Neurosurgery , Turku University Hospital and University of Turku , Turku , Finland.
authors.forename: Anna
authors.initials: A
authors.lastname: Kotkansalo
authors.affiliation: f Division of Clinical Neurosciences, Department of Neurosurgery , Turku University Hospital and University of Turku , Turku , Finland.
authors.forename: Melissa
authors.initials: M
authors.lastname: Rahi
authors.affiliation: f Division of Clinical Neurosciences, Department of Neurosurgery , Turku University Hospital and University of Turku , Turku , Finland.
authors.forename: Matti
authors.initials: M
authors.lastname: Sankinen
authors.affiliation: f Division of Clinical Neurosciences, Department of Neurosurgery , Turku University Hospital and University of Turku , Turku , Finland.|g Division of Clinical Neurosciences, Department of Rehabilitation and Brain Trauma , Turku University Hospital and University of Turku and University of Turku , Turku , Finland.
authors.forename: Jussi
authors.initials: J
authors.lastname: Posti
authors.affiliation: a Perioperative Services, Intensive Care Medicine and Pain Management , Turku University Hospital and University of Turku , Turku , Finland.
authors.forename: Ari
authors.initials: A
authors.lastname: Katila
authors.affiliation: e Department of Clinical Medicine, Biostatistics , University of Turku, and Turku University Hospital , Turku , Finland.
authors.forename: Jaakko
authors.initials: J
authors.lastname: Rinne
mesh_terms: D000328:Adult; D000368:Aged; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood* / Q000172:deficiency; D007206:Individuality; D002532:Intracranial Aneurysm / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010907:Pituitary Hormones / Q000097:blood*; D011388:Prolactin / Q000097:blood*; D013345:Subarachnoid Hemorrhage / Q000097:blood* / Q000209:etiology; D013739:Testosterone / Q000097:blood* / Q000172:deficiency
chemical_list: D010907:Pituitary Hormones; D013739:Testosterone; D011388:Prolactin; D006854:Hydrocortisone
keywords: Hypocortisolism; pituitary function; prolactin; subarachnoid hemorrhage