Follow-up of the serum concentration of pituitary hormones after spontaneous subarachnoid hemorrhage

Abstract

Objective To explore the risk of pituitary dysfunction for spontaneous subarachnoid hemorrhage(s-SAH)patients and to evaluate its correlation with clinical data. Methods 63 cases of patients with s-SAH were selected. Indicators(serum adrenocorti cotrophic hormone(ACTH), growth hormone(GH), insulin-like growth factor-1(IGF-1), thyroid stimulating hormone(TSH), thyroxine(T4), triiodothyronine(T3), follicle-stimulating hormone(FSH), luteinizing hormone(LH), total testosterone(in males), estradiol(in females)and prolactin)dynamic observation were tested 7 days, 1 year, 2 years, 3 years after the onset. Results Thirty patients(47.6%)had some type of pituitary dysfunction. ACTH deficiency was the most frequent disorder(14.3%), followed by GH deficiency(12.7%), hypogonadatrophic(6.3%), hypothyroidism(3.2%)and high prolactin(1.6%). six patients(9.5%)showed deficiencies in more than one axis. Hormone deficiency was related to vasospasm, Fisher grade 4(P<0.05)and recovery time. Conclusions A greater incidence of hormone deficiency after s-SAH was related with vasospasm, Fisher grade and recovery time. Follow-up time should be extended. Key words: Spontaneous subarachnoid hemorrhage; Pituitary hormone; Cerebral vasospasm