Aneurysmal subarachnoid hemorrhage (aSAH) results in low prevalence of neuro-endocrine dysfunction and NOT deficiency

• Verfasst von: Lammert, Alexander [VerfasserIn]
• Verfasst von: Hammes, Hans-Peter [VerfasserIn]
• Verfasst von: Birck, Rainer [VerfasserIn]
• Verfasst von: Fatar, Marc [VerfasserIn]
• Verfasst von: Zohsel, Katrin [VerfasserIn]
• Verfasst von: Schmieder, Kirsten [VerfasserIn]
• Titel: Aneurysmal subarachnoid hemorrhage (aSAH) results in low prevalence of neuro-endocrine dysfunction and NOT deficiency
• Verf.angabe: Alexander Lammert, Hinrich Bode, Hans-Peter Hammes, Rainer Birck, Marc Fatar, Katrin Zohsel, Kirsten Schmieder, Gerrit Alexander Schubert, Claudius Thomé, Marcel Seiz
• Jahr: 2012
• Umfang: 8 S.
• Fussnoten: Published online: 29 October 2011 ; Gesehen am 21.08.2018
• Titel Quelle: Enthalten in: Pituitary
• Ort Quelle: Dordrecht [u.a.] : Springer Science + Business Media B.V, 1998
• Jahr Quelle: 2012
• Band/Heft Quelle: 15(2012), 4, Seite 505-512
• ISSN Quelle: 1573-7403
• DOI: doi:10.1007/s11102-011-0357-5
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Aneurysmal subarachnoid hemorrhage
• Sach-SW: Glasgow outcome scale
• Sach-SW: Neuro-endocrine dysfunction
• Sach-SW: Neuropsychological deficits
• K10plus-PPN: 1580249515

Abstract

Neuro-endocrine deficiencies have been argued to be common sequelae after aneurysmal subarachnoid hemorrhage (aSAH). As this, however, does not resemble our clinical experience, we studied the incidence of neuro-endocrine and neuropsychological deficits after aSAH. Twenty-six patients (20 females) were prospectively screened for neuro-endocrine and neuropsychological deficits 3, 6 and 12 months after aSAH. GH, IGF-1, prolactin, LH, FSH, estradiol, testosterone, ACTH as well as cortisol during ACTH-stimulation were assessed. Neuropsychological analysis covered verbal comprehension, short term and working memory, visuospatial construction, figural memory, psychomotor speed, attention, and concentration. During the study period 5 individuals demonstrated neuro-endocrine dysfunction. Hypogonadotrophic hypogonadism resolved spontaneously in 2 patients and central hypothyroidism in one of these patients during the study. After 12 months three patients presented low IGF-1 levels. 73.9% of our cohort was affected by neuropsychological deficits during follow-up. At 3, 6 and 12 months the prevalences were 56.5, 52.6 and 42.1%, respectively. Interestingly, all patients with neuro-endocrine dysfunction presented impaired clinical outcome with a GOS 4 at some time point of the study (GOS 4 vs. 5, 45.5% vs. 0, P = 0.007). We found a low prevalence of neuro-endocrine and a high prevalence of neuropsychological deficits in patients 3, 6 and 12 months after aSAH without significant interrelation. Spontaneous recovery of neuro-endocrine alterations most likely presents an adaption to or dysfunction after severe illness. This hypothesis is strengthened by the fact that only patients with inferior clinical outcome after aSAH as assessed by GOS demonstrated neuro-endocrine dysfunction.