Fatigue after aneurysmal subarachnoid hemorrhage evaluated by pituitary function and 3D-CBF

Area of Science:

• Neurology
• Endocrinology
• Radiology

Background:

• Fatigue is a common, yet poorly understood, consequence of aneurysmal subarachnoid hemorrhage (SAH).
• The proximity of supratentorial aneurysms to the hypothalamus and pituitary gland suggests a potential for endocrine dysfunction.
• Investigating pituitary function is crucial for understanding post-SAH fatigue.

Purpose of the Study:

• To investigate the relationship between aneurysmal subarachnoid hemorrhage (SAH) and pituitary function.
• To explore the role of endocrine dysfunction in persistent fatigue following SAH.
• To assess regional cerebral blood flow (CBF) using SPECT in patients with post-SAH fatigue.

Main Methods:

• Evaluated pituitary function in ten patients experiencing fatigue after SAH.
• Utilized 3D-CBF (SPECT) imaging to assess regional brain perfusion.
• Assessed hormonal levels, including gonadotropins and insulin-like growth factor I (IGF-I).

Main Results:

• Pituitary dysfunction was identified in five patients, with gonadotropin disturbances noted in three.
• Mean insulin-like growth factor I (IGF-I) levels were at the lower end of the normal range.
• SPECT revealed pathological changes in the basal region's central structures in patients with endocrine dysfunction.

Conclusions:

• Aneurysmal SAH can lead to partial impairment of pituitary function.
• This pituitary deficit may contribute to, but not fully explain, fatigue after SAH.
• SPECT imaging can identify regional tissue damage associated with pituitary dysfunction post-SAH.