Document Detail


Subarachnoid hemorrhage as a cause of hypopituitarism.
MedLine Citation:
PMID:  16508714     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Common causes of pituitary insufficiency include pathologies such as pituitary adenomas, other intra- and parasellar tumors, as well inflammatory, surgical or radiation-induced destruction of pituitary tissue. More recently, hypopituitarism has also been identified as a frequent sequel of traumatic brain injury (TBI). Despite the close anatomical relationship between pituitary gland, hypothalamic structures and the arteries of the circle of Willis and the observation that many bodily and psychosocial long-term sequelae of survivors of aneurysmal subarachnoid hemorrhage (SAH) resemble those of patients with untreated hypopituitarism, aneurysmal SAH has so far been considered a rare cause of endocrine abnormalities. However, in recent clinical investigations partial hypopituitarism has been diagnosed in 37.5-55% of SAH survivors. At present, many questions concerning the most appropriate diagnostic work-up, the clinical implications of hormone deficiencies and relative importance of hormone replacement in this patient group are not yet satisfactorily clarified. This article gives an overview of the historical and current studies on hypopituitarism as a consequence of aneurysmal SAH, which show that neuroendocrine deficiency occurs more often than has so far been appreciated. Despite the still unresolved issues, endocrine abnormalities should be considered a cause for impaired recovery and long-term morbidity in SAH-survivors. Enhanced awareness of physicians treating SAH-patients for post-traumatic hypopituitarism is called for, so that screening for hormone deficiencies and appropriate replacement therapy can be initiated.
Authors:
Ilonka Kreitschmann-Andermahr
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Publication Detail:
Type:  Historical Article; Journal Article; Review    
Journal Detail:
Title:  Pituitary     Volume:  8     ISSN:  1386-341X     ISO Abbreviation:  Pituitary     Publication Date:  2005  
Date Detail:
Created Date:  2006-03-27     Completed Date:  2007-10-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9814578     Medline TA:  Pituitary     Country:  United States    
Other Details:
Languages:  eng     Pagination:  219-25     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, University Hospital, RWTH Aachen Pauwelsstrasse 30, D-52074, Aachen, Germany.
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MeSH Terms
Descriptor/Qualifier:
History, 20th Century
Hormone Replacement Therapy
Humans
Hypopituitarism / drug therapy,  etiology*,  pathology
Intracranial Aneurysm / complications
Neurosecretory Systems / physiopathology
Pituitary Hormones / deficiency
Subarachnoid Hemorrhage / complications*,  history
Chemical
Reg. No./Substance:
0/Pituitary Hormones

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


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