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Neurocritical Care
Published in: Neurocritical Care 2/2011

01-10-2011 | Review

SAH Pituitary Adrenal Dysfunction

Authors: P. Vespa, The Participants in the International Multi-disciplinary Consensus Conference on the Critical Care Management of Subarachnoid Hemorrhage

Published in: Neurocritical Care | Issue 2/2011

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Abstract

Disruption of the hypothalamic–pituitary–adrenal axis may occur after aneurysmal subarachnoid hemorrhage, resulting in hypopituitarism. An electronic literature search was conducted to identify articles with English-language abstracts published between 1980 and March 2011 that addressed hypothalamic–pituitary–adrenal axis insufficiency and hormone replacement. A total of 18 observational and prospective, randomized studies were selected for this review. Limited data are available evaluating pituitary effects during the acute stage after subarachnoid hemorrhage, with inconsistent results reported. Overall, acutely after subarachnoid hemorrhage, cortisol levels may initially be supranormal, decreasing toward normal levels over time. During the months to years after subarachnoid hemorrhage, pituitary deficiency may occur in up to one in three patients. Limited data suggest modest outcome benefits with fludrocortisone and no benefit or harm from corticosteroids.
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Metadata
Title
SAH Pituitary Adrenal Dysfunction
Authors
P. Vespa
The Participants in the International Multi-disciplinary Consensus Conference on the Critical Care Management of Subarachnoid Hemorrhage
Publication date
01-10-2011
Publisher
Humana Press Inc
Published in
Neurocritical Care / Issue 2/2011
Print ISSN: 1541-6933
Electronic ISSN: 1556-0961
DOI
https://doi.org/10.1007/s12028-011-9595-7

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