Neuro-Endocrine and Neuropsychological Outcome After Aneurysmal Subarachnoid Hemorrhage (aSAH): A Prospective Cohort Study

作者：Lammert A^*; Bode H; Hammes H P; Birck R; Fatar M; Zohsel K; Braun J; Schmieder K; Diepers M; Schubert G A; Barth M; Thome C; Seiz M

来源：Experimental and Clinical Endocrinology & Diabetes, 2011, 119(2): 111-116.

DOI：10.1055/s-0030-1262815

• hypopituitarism
• aneurysmal subarachnoid hemorrhage
• neuropsychological deficit

Objective: Neuropsychological sequelae are common after aneurysmal subarachnoid hemorrhage (aSAH) and may be associated with or caused by supposed hypothalamic-pituitary dysfunction. We evaluated the incidence of neuroendocrine and neuropsychological deficits after aSAH and their interrelations in a standardized manner.
Methods: 26 patients (20 females) were prospectively screened for neuro-endocrine and neuropsychological deficits 3 and 6 months after aSAH. We measured GH, IGF-1, prolactin, LH, FSH, estradiol, TSH, fT4, total T3, testosterone, ACTH as well as cortisol before and after ACTH-stimulation. Neuropsychological analysis covered verbal comprehension, short term and working memory, visuospatial construction, figural memory, psychomotor speed, attention, and concentration.
Results: After 3 months central hypogonadism was observed in 2 patients accompanied by central hypothyroidism in 1 male subject. Central hypogonadism resolved spontaneously after 6 months in both. After 3 months, neuropsychological deficits were detected in 57% of the examined patients (44% attention deficits, 38% memory impairment, 12% psychomotor deficits). Neuropsychological deficits were still present in 53% after 6 months.
Conclusion: We found a low prevalence of neuro-endocrine and a high prevalence of neuropsychological deficits in patients 3 and 6 months after aSAH. Thus, the absent co-incidence of central hormonal and psychological dysfunction leaves a causal association questionable.

• 出版日期2011-2