Prevalence of hypopituitarism in patients with cerebrovascular diseases

Stroke is one of the main causes of death and disability in the adult population. Changes in pituitary hormone secretion may be observed during the acute phase of stroke, representing part of the adaptive response to injury. However, reduced pituitary hormone secretion, caused by pituitary and/or hypothalamus damage, may also occur. Hypopituitarism has been observed in 19% of patients with ischemic stroke and 47% of patients with subarachnoid hemorrhage, presenting as an isolated deficiency in most cases. Diabetes insipidus is very rare. Low IGF-I levels, during the acute phase of stroke, have been associated with poor outcome and high mortality. During rehabilitation, higher IGF-I levels have been observed in patients with better outcome, suggesting a neuroprotective role of IGF-I. Accurate evaluation and long-term follow-up of all patients with stroke are necessary to define the prevalence of hypopituitarism, and its relationship with type, severity, and outcome from stroke. Discovery and adequate treatment of possible endocrine deficiencies may improve outcome and quality of life of patients with stroke.