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Pre-Chiasmatic, Single Injection of Autologous Blood to Induce Experimental Subarachnoid Hemorrhage in a Rat Model
Published on: June 18, 2021
Hypothalamo-pituitary dysfunction in patients with chronic subdural hematoma
1Third Department of Internal Medicine of General Faculty Hospital, Charles University, Prague, Czech Republic. vhana@lf1.cuni.cz
Physiological Research
|February 2, 2012
Summary
Pituitary hormone deficiencies, including hypogonadism and growth hormone deficiency, can occur after subdural hematoma (SDH) evacuation but are often transient. Neuroendocrine dysfunction is less frequent than after TBI or SAH.
Area of Science:
- Neuroendocrinology
- Neurosurgery
- Endocrinology
Background:
- Pituitary hormone deficiencies are common after traumatic brain injury (TBI) and subarachnoid hemorrhage (SAH).
- Neuroendocrine consequences of TBI are frequently underdiagnosed.
- Subdural hematoma (SDH) is a significant neurosurgical condition with potential endocrine implications.
Purpose of the Study:
- To evaluate hypothalamo-pituitary functions in patients after subdural hematoma (SDH) evacuation.
- To assess the incidence and character (transient vs. permanent) of pituitary hormone deficiencies post-SDH.
- To compare the frequency of neuroendocrine dysfunction in SDH patients with those post-TBI or SAH.
Main Methods:
- A cohort of 59 patients (49 males, mean age 68.3 years) undergoing SDH evacuation was studied.
- Hypothalamo-pituitary functions were assessed one week, three months, and one year after surgery.
- Hormone levels were evaluated, including assessment for growth hormone deficiency (GHD) using the GHRH+arginine test.
Main Results:
- Hypogonadism was observed in 26% of patients acutely, predominantly transient.
- Less than half of the patients exhibited growth hormone deficiency (GHD).
- No serious cases of hypocortisolism, hypothyroidism, central diabetes insipidus, or SIADH were found; transient hypocortisolism resolved in two patients.
Conclusions:
- Growth hormone deficiency and hypogonadism can occur in patients with SDH.
- Serious pituitary hormone deficits are infrequent after SDH evacuation compared to TBI or SAH.
- Consideration of neuroendocrine dysfunction is warranted in SDH patients, though less common than in TBI/SAH cohorts.
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