Progress in clinical diagnosis and treatment of hypopituitorism after aneurysmal subarachnoid hemorrhage / 中华内分泌外科杂志

ABSTRACT

Hypopituitorism is not uncommon in patients with aneurysmal subarachnoid hemorrhage (aSAH) . It can happen both in acute and chronic stages of aSAH. There are different clinical features of hypopituitorism happened in acute and chronic stages. In the acute stage, pituitary-adrenocortical axis dysfunction is of the most clinically significant, which can cause adrenal crisis. Growth hormone deficiency and pituitary-adrenocortical axis dysfunction are the two most common endocrine deficits in the chronic stage, symptoms include fatigue, decreased exercise capacity, cognitive impairment and decreased libido et al. The mechanism and risk factors of hypopituitorism are still unclear. The function of pituitary-adrenal axis should be paid attention for patients with aSAH during the acute phase. If patients manifest symptoms related to hypopituitorism during the chronic stage, comprehensive evaluation of pituitary function should be carried out. The diagnosis of hypopituitorism should be based on basic hormone level and corresponding stimulation test. Hypocortisolism in the acute phase of aSAH should be treated with glucocorticoid because of its potential contribution to the morbidity and mortality. Hypopituitorism occurred in the chronic phase of aSAH may have lasting effect on cognition and life quality, and hormone replacement should be carried out once the diagnosis be confirmed.