High risk of pituitary dysfunction due to aneurysmal subarachnoid haemorrhage: a prospective investigation of anterior pituitary function in the acute phase and 12 months after the event

Abstract

Objective: Recent investigations have provided evidence for a high prevalence of pituitary dysfunction in patients with subarachnoid haemorrhage (SAH). However, apart from one study, all of the previous data were obtained from retrospective studies. To our knowledge there is no previously reported study in which pituitary function was investigated in the same patients immediately after SAH and 12 months later. The aim of this study was to understand the prevalence and progression of anterior pituitary hormone deficiencies both in the acute phase of SAH and 12 months after the event.

Patients and design: Twenty-two SAH patients (11 men, 11 women) were included in the study. Pituitary function was evaluated in the early acute phase (within 24 h of admission) and after 12 months.

Results: Pituitary hormone deficiencies in the acute phase were as follows: 31.8% had gonadotrophin, 22.7% had ACTH and 22.7% had GH deficiencies. At 12 months after SAH: 0.0% had gonadotrophin, 13.6% had ACTH and 36.4% had GH deficiencies. Overall, after 12 months, pituitary hormone deficiencies recovered in 15 (68.2%) patients and new-onset pituitary hormone deficiencies were present in nine (40.9%) patients.

Conclusions: GH deficiency (GHD) was the most common pituitary deficit at 12 months after SAH and the majority of the patients (87.5%) had isolated GHD. During the 12-month follow-up, pituitary function was found to either improve or worsen in a considerable number of patients.