Exp Clin Endocrinol Diabetes 2011; 119(2): 111-116
DOI: 10.1055/s-0030-1262815
Article

© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

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

A. Lammert1 , H. Bode1 , H.-P. Hammes1 , R. Birck1 , M. Fatar2 , K. Zohsel2 , J. Braun3 , K. Schmieder3 , M. Diepers4 , G. A. Schubert3 , M. Barth3 , C. Thomé3 , 5 , M. Seiz3 , 5
  • 1VthDepartment of Medicine, University Medical Center Mannheim,Mannheim, Germany
  • 2Department of Neurology, University Medical Center Mannheim,Mannheim, Germany
  • 3Department of Neurosurgery, University Medical Center Mannheim, Mannheim, Germany
  • 4Department of Neuroradiology, University Medical Center Mannheim, Germany
  • 5Department of Neurosurgery, Medical University Innsbruck, Innsbruck, Austria
Further Information

Publication History

received 26.03.2010 first decision 31.05.2010

accepted 08.07.2010

Publication Date:
05 August 2010 (online)

Abstract

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 neuro-endocrine 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.

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Correspondence

A. Lammert

Vth Department of Medicine

University Medical Center Mannheim

Theodor-Kutzer-Ufer 1–3

68167 Mannheim

Phone: +49/621/383 3370

Fax: +49/621/383 2159

Email: alexander.lammert@umm.de

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