Pituitary dysfunction after aneurysmal subarachnoid haemorrhage
| Autor: | Diederik W.J. Dippel, Majanka H. Heijenbrok-Kal, Gerard M. Ribbers, H. J. G. van den Berg-Emons, Ladbon Khajeh, A. J. van der Lely, F van Kooten, Karin Blijdorp, Emiel M Sneekes, S.J.C.M.M. Neggers |
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| Přispěvatelé: | Neurology, Internal Medicine, Rehabilitation Medicine |
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
REHABILITATION
Male medicine.medical_specialty Subarachnoid hemorrhage Pituitary Diseases CLINICAL NEUROLOGY Logistic regression Growth hormone deficiency Quality of life Pituitary Gland Anterior Risk Factors Internal medicine Medicine SUBARACHNOID HAEMORRHAGE Humans Prospective Studies cardiovascular diseases Prospective cohort study business.industry Gonadotropin deficiency Middle Aged Subarachnoid Hemorrhage medicine.disease Surgery Hydrocephalus nervous system diseases Psychiatry and Mental health ENDOCRINOLOGY Cerebrovascular Disease Female Neurology (clinical) business Complication Gonadotropins |
| Zdroj: | Journal of Neurology, Neurosurgery, and Psychiatry Journal of Neurology Neurosurgery and Psychiatry, 86(8), 905-910. BMJ Publishing Group |
| ISSN: | 0022-3050 |
| Popis: | Objective We describe the occurrence and course of anterior pituitary dysfunction (PD) after aneurysmal subarachnoid haemorrhage (SAH), and identify clinical determinants for PD in patients with recent SAH. Methods We prospectively collected demographic and clinical parameters of consecutive survivors of SAH and measured fasting state endocrine function at baseline, 6 and 14 months. We included dynamic tests for growth-hormone function. We used logistic regression analysis to compare demographic and clinical characteristics of patients with SAH with and without PD. Results 84 patients with a mean age of 55.8 (±11.9) were included. Thirty-three patients (39%) had PD in one or more axes at baseline, 22 (26%) after 6 months and 6 (7%) after 14 months. Gonadotropin deficiency in 29 (34%) patients and growth hormone deficiency (GHD) in 26 (31%) patients were the most common deficiencies. PD persisted until 14 months in 6 (8%) patients: GHD in 5 (6%) patients and gonadotropin deficiency in 4 (5%). Occurrence of a SAH-related complication was associated with PD at baseline (OR 2.6, CI 2.2 to 3.0). Hydrocephalus was an independent predictor of PD 6 months after SAH (OR 3.3 CI 2.7 to 3.8). PD was associated with a lower score on health-related quality of life at baseline (p=0.06), but not at 6 and 14 months. Conclusions Almost 40% of SAH survivors have PD. In a small but substantial proportion of patients GHD or gonadotropin deficiency persists over time. Hydrocephalus is independently associated with PD 6 months after SAH. Trial registration number NTR 2085. |
| Databáze: | OpenAIRE |
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