Document Detail


Hypopituitarism after surgical clipping of a ruptured cerebral aneurysm.
MedLine Citation:
PMID:  11700429     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The causes of hypopituitarism in adult life are most frequently cerebral tumors, pituitary infarction, head trauma, pituitary surgery, or irradiation. We report a case of hypopituitarism after surgical clipping of a ruptured cerebral aneurysm. Two previous cases after the rupture of a cerebral aneurysm have been reported. DESIGN: Case report. PATIENTS: One 42-yr-old man. MEASUREMENTS AND MAIN RESULTS: A 42-yr-old man was admitted as an emergency for unconsciousness. The computed tomography showed a massive subarachnoid hemorrhage, and specific angiography showed an aneurysm in the internal carotid. The aneurysm was successfully clipped through craniotomy. The patient's hospital course was marked by a few episodes of pulmonary infection, and a tracheotomy was performed. The patient was transferred to the rehabilitation unit; he received a rating of 9 on the Glasgow Coma Scale. Seven months after rupture of the aneurysm, the patient was readmitted to the intensive care unit for septic shock, with pulmonary infection associated with vomiting and diarrhea. Despite standard therapy and inotropic support, there was no improvement of his clinical condition. Adrenal failure was then suspected. Treatment was started immediately with hydrocortisone (50 mg) four times a day. Within hours, his clinical condition improved. The following month, the patient was weaned off his tracheotomy and had nearly recovered. Endocrine tests confirmed the cortisol insufficiency but also hypothyroidism and hypogonadotropic hypogonadism secondary to hypopituitarism. CONCLUSION: Our case is the first one reported of hypopituitarism after surgical clipping of a ruptured cerebral aneurysm.
Authors:
M Vernet; T Rapenne; J Beaurain; B Verges; J C Combes; M Freysz
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Critical care medicine     Volume:  29     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2001 Nov 
Date Detail:
Created Date:  2001-11-08     Completed Date:  2001-12-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2220-2     Citation Subset:  AIM; IM    
Affiliation:
Département d'Anesthésie réanimation, Hôpital Général, CHU Dijon, Dijon Cedex, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Craniotomy
Critical Care
Glasgow Coma Scale
Humans
Hydrocortisone / therapeutic use
Hypopituitarism / etiology*
Intracranial Aneurysm / complications*,  surgery
Male
Rupture
Subarachnoid Hemorrhage / complications,  etiology*
Surgical Instruments
Chemical
Reg. No./Substance:
50-23-7/Hydrocortisone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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