Hypothalamo-Pituitary Dysfunction in Patients With Chronic Subdural Hematoma

0382381 - ÚI 2013 RIV CZ eng J - Journal Article
Hána, V. - Kosák, M. - Masopust, V. - Netuka, D. - Lacinová, Z. - Kršek, M. - Marek, J. - Pecen, Ladislav
Hypothalamo-Pituitary Dysfunction in Patients With Chronic Subdural Hematoma.
Physiological Research. Roč. 61, č. 2 (2012), s. 161-167. ISSN 0862-8408. E-ISSN 1802-9973
Grant - others:GA MZd(CZ) NS9794
Institutional research plan: CEZ:AV0Z10300504
Keywords : hypopituitarism * subdural hematoma * brain injury * growth hormone deficiency
Subject RIV: ED - Physiology
Impact factor: 1.531, year: 2012

Relatively frequent pituitary hormone deficiencies are observed after traumatic brain injury (TBI) and subarachnoid hemorrhage (SAH) and according to the published studies the neuroendocrine consequenses of traumatic brain injury are underdiagnosed. In a cohort of 59 patients (49 males, mean age 68.3 years, 36-88 years) after evacuation of subdural hematoma (SDH) were evaluated hypothalamo-pituitary functions one week after surgery, after three months and after one year. Hypogonadism was present in 26 % of patients in an acute phase, but in the majority had a transient character. Less than half of patients was GH deficient (GHD) according to the GHRH+arginine test. We did not find any serious case of hypocortisolism, hypothyroidism, diabetes insipidus centralis nor syndrome of inappropriate secretion of ADH (SIADH). Transient partial hypocortisolism was present in two cases, but resolved. We did not find relation between extension of SDH or clinical severity and development of hypopituitarism. In conclusion, in some patients with SDH growth hormone deficiency or hypogonadism was present. No serious hypocortisolism, hypothyroidism, diabetes insipidus nor SIADH was observed. The possibility of neuroendocrine dysfunction should be considered in patients with SDH, although the deficits are less frequent than in patients after TBI or SAH.
Permanent Link: http://hdl.handle.net/11104/0212613