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Updated: May 30, 2026
09:14
Pre-Chiasmatic, Single Injection of Autologous Blood to Induce Experimental Subarachnoid Hemorrhage in a Rat Model
Published on: June 18, 2021
Endocrine function following acute SAH.
1Division of Neurosurgery, David Geffen School of Medicine at UCLA, University of California, Room 6236A Ronald Reagan UCLA Medical Center, 750 Westwood Blvd, Los Angeles, CA 90095, USA. PVespa@mednet.ucla.edu
Neurocritical Care
|August 3, 2011
Summary
Aneurysmal subarachnoid hemorrhage can disrupt the hypothalamic-pituitary-adrenal axis, leading to hypopituitarism. Up to one-third of patients may develop pituitary deficiency months to years after the event.
Area of Science:
- Endocrinology
- Neurology
- Neurosurgery
Background:
- Subarachnoid hemorrhage can disrupt the hypothalamic-pituitary-adrenal (HPA) axis.
- This disruption may lead to hypopituitarism, affecting hormone production.
- The HPA axis is crucial for stress response and metabolic regulation.
Purpose of the Study:
- To review the literature on HPA axis insufficiency after aneurysmal subarachnoid hemorrhage (aSAH).
- To evaluate hormone replacement strategies for patients with aSAH-induced hypopituitarism.
- To assess the available data on pituitary effects in the acute and chronic stages post-aSAH.
Main Methods:
- An electronic literature search was performed for studies published between 1980 and March 2011.
- Included studies focused on HPA axis insufficiency and hormone replacement post-aSAH.
- A total of 18 observational and randomized studies were selected for review.
Main Results:
- Limited data exist for the acute phase post-aSAH, with inconsistent findings on pituitary function.
- Cortisol levels may be initially high, normalizing over time.
- Pituitary deficiency occurs in up to one-third of patients months to years after aSAH.
Conclusions:
- Hypopituitarism is a significant concern following aneurysmal subarachnoid hemorrhage.
- Long-term monitoring of HPA axis function is warranted.
- Fludrocortisone may offer modest benefits, while corticosteroid use shows no clear advantage.
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