Anterior Pituitary Function in Cerebrovascular Disease

Ruptured Cerebral Aneurysm Cases

Abstract

Systematic anterior pituitary function tests were performed in 53 patients with ruptured cerebral aneurysm, and the results were assessed for correlation with various clinical factors.
The subjects were 24 patients with aneurysm of the anterior communicating artery, 14 with aneurysm of the internal carotid-posterior communicating artery, 7 with aneurysm of the middle cerebral artery, 3 with aneurysm of the posterior inferior cerebellar artery, 2 with aneurysm of the peripheral anterior cerebral artery, 2 with aneurysm of bifurcation of the internal carotid artery, and 1 with aneurysm of the superior cerebellar artery. In the radio-immunoassay, growth hormone and cortisol were determined during the insulin tolerance test (regular insulin, 0.15-0.20 U/kg), luteinizing hormone and follicle stimulating hormone under luteinizing hormone-releasing hormone (100 μg), thyroid stimulating hormone and prolactin under thyrotropin-releasing hormone (500 μg). The impaired rate was calculated for each patient as the number of impaired anterior pituitary hormone secretions divided by the number of effectively examined anterior pituitary hormones. The data were assessed statistically by a variance analysis for age, sex, clinical symptoms, disease stage at the test time, complications, and location of the aneurysm, and the impaired rate. The results were as follows. 1) Growth hormone, thyroid stimulating hormone, cortisol, luteinizing hormone, prolactin, and follicle stimulating hormone secretions were impaired in 52%, 45%, 23%, 15%, 11%, and 9% of the cases, respectively. 2) The case incidence of impaired anterior pituitary hormonal secretion was 77%, but its intensity was mild in most of the patients. 3) The impaired rate was significantly higher in patients with a high-grade or early-stage subarachnoid hemorrhage, complication such as hydrocephalus or angiospasm, and aneurysm of the anterior communicating artery.