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Hypopituitarism after subarachnoid haemorrhage, do we know enough?
Ladbon Khajeh1, Karin Blijdorp2, Sebastian Jcmm Neggers3
1Department of Neurology, Erasmus MC University Medical Centre, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands. l.khajeh@erasmusmc.nl.
BMC Neurology
|October 15, 2014
Summary
Subarachnoid hemorrhage (SAH) can cause long-term fatigue and apathy due to pituitary dysfunction. Addressing neuroendocrine issues may improve functional recovery after SAH.
Area of Science:
- Neuroendocrinology
- Neurosurgery
- Endocrinology
Background:
- Subarachnoid hemorrhage (SAH) frequently leads to long-term complaints such as fatigue, slowness, and apathy.
- These symptoms overlap with those seen in endocrine dysfunction, suggesting a potential link to pituitary issues post-SAH.
- Pituitary dysfunction can arise as a direct consequence of SAH or its complications.
Purpose of the Study:
- To investigate the occurrence, pattern, and severity of endocrine abnormalities following SAH.
- To identify potential risk factors associated with hypopituitarism after SAH.
- To assess the impact of hypopituitarism on long-term functional recovery in SAH patients.
Main Methods:
- Conducted a MEDLINE search (1995-2014) using terms related to SAH and pituitary/endocrine function.
- Selected case-series and cohort studies reporting endocrine function at least 3 months post-SAH.
- Analyzed reported prevalence, pathogenesis, risk factors, clinical course, and outcomes of pituitary dysfunction.
Main Results:
- Sixteen studies were identified, detailing long-term pituitary function after SAH.
- The prevalence of endocrine dysfunction varied widely (0-55%), with differing affected pituitary axes across studies.
- Methodological limitations precluded definitive conclusions on risk factors, clinical course, or outcomes.
Conclusions:
- Neuroendocrine dysfunction is a significant, potentially modifiable factor influencing poor functional outcomes after SAH.
- There is a critical need for robust prospective studies to accurately determine the incidence and clinical impact of neuroendocrine dysfunction.
- Further research should focus on the effects of neuroendocrine dysfunction on mood, behavior, and quality of life post-SAH.
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