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Double Direct Injection of Blood into the Cisterna Magna as a Model of Subarachnoid Hemorrhage
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Pituitary dysfunction after aneurysmal subarachnoid haemorrhage: course and clinical predictors—the HIPS study
L Khajeh1, K Blijdorp2, M H Heijenbrok-Kal3
1Department of Neurology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands.
Journal of Neurology, Neurosurgery, and Psychiatry
|November 8, 2014
Summary
Anterior pituitary dysfunction (PD) affects nearly 40% of aneurysmal subarachnoid hemorrhage (SAH) survivors, with growth hormone deficiency and gonadotropin deficiency being most common. Hydrocephalus is a key predictor of developing PD post-SAH.
Area of Science:
- Neuroendocrinology
- Neurosurgery
- Endocrinology
Background:
- Aneurysmal subarachnoid hemorrhage (SAH) can lead to long-term neurological and endocrine complications.
- Anterior pituitary dysfunction (PD) is a potential consequence, impacting hormonal balance and quality of life.
Purpose of the Study:
- To describe the incidence and progression of anterior pituitary dysfunction (PD) following aneurysmal subarachnoid hemorrhage (SAH).
- To identify clinical factors associated with the development of PD in SAH survivors.
- To assess the long-term persistence of PD and its impact on quality of life.
Main Methods:
- Prospective collection of demographic and clinical data from SAH survivors.
- Measurement of fasting state endocrine function at baseline, 6, and 14 months, including dynamic tests for growth hormone.
- Logistic regression analysis to identify predictors of PD.
Main Results:
- 39% of patients exhibited PD at baseline, decreasing to 7% at 14 months.
- Gonadotropin deficiency (34%) and growth hormone deficiency (31%) were the most frequent PD types.
- Hydrocephalus independently predicted PD at 6 months post-SAH (OR 3.3).
Conclusions:
- Nearly 40% of SAH survivors develop anterior pituitary dysfunction.
- A small but significant percentage experience persistent growth hormone or gonadotropin deficiency.
- Hydrocephalus is a significant risk factor for developing PD 6 months after SAH.
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