Disruption of the hypothalamic-pituitary-adrenal axes may occur after aneurysmal subarachnoid hemorrhage, resulting in hypopituitarism. An electronic literature search was conducted to identify articles with English-language abstracts published between 1980 and March 2011, which addressed hypothalamic-pituitary-adrenal axis insufficiency and hormone replacement. A total of 18 observational and prospective, randomized studies were selected for this review. Limited data are available, evaluating pituitary effects during the acute stage after subarachnoid hemorrhage, with inconsistent results being reported. Overall, after acute subarachnoid hemorrhage, cortisol levels may initially be supranormal, decreasing toward normal levels over time. During the months to years after subarachnoid hemorrhage, pituitary deficiency may occur in one out of three patients. Limited data suggest modest outcome benefits with fludrocortisone and no benefit or harm from corticosteroids.
Endocrine function following acute SAH / P. Vespa, M.N. Diringer, T.P. Bleck, N. Bruder, E.S. Connolly Jr, G. Citerio, D. Gress, D. Hanggi, J.C. Hemphill 3rd, B. Hoh, G. Lanzino, P. Le Roux, D. Menon, A. Rabinstein, E. Schmutzhard, L. Shutter, N. Stocchetti, J. Suarez, M. Treggiari, M.Y. Tseng, M. Vergouwen, S. Wolf, G.J. Zipfel. - In: NEUROCRITICAL CARE. - ISSN 1541-6933. - 15:2(2011), pp. 361-364.
Endocrine function following acute SAH
N. Stocchetti;
2011
Abstract
Disruption of the hypothalamic-pituitary-adrenal axes may occur after aneurysmal subarachnoid hemorrhage, resulting in hypopituitarism. An electronic literature search was conducted to identify articles with English-language abstracts published between 1980 and March 2011, which addressed hypothalamic-pituitary-adrenal axis insufficiency and hormone replacement. A total of 18 observational and prospective, randomized studies were selected for this review. Limited data are available, evaluating pituitary effects during the acute stage after subarachnoid hemorrhage, with inconsistent results being reported. Overall, after acute subarachnoid hemorrhage, cortisol levels may initially be supranormal, decreasing toward normal levels over time. During the months to years after subarachnoid hemorrhage, pituitary deficiency may occur in one out of three patients. Limited data suggest modest outcome benefits with fludrocortisone and no benefit or harm from corticosteroids.
Pubblicazioni consigliate
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
