Fatigue after aneurysmal subarachnoid hemorrhage evaluated by pituitary function and 3D-CBF

Abstract

Objective - The reason for longstanding fatigue following aneurysmal subarachnoidal hemorrhage (SAH) is still not clarified. The bleed from supratentorial aneurysms is often in the vicinity of the hypothalamus and pituitary gland making an endocrine dysfunction plausible. Methods - Ten patients with post-SAH fatigue were investigated with 3D-CBF (SPECT) and underwent an evaluation of the pituitary function. Results - Five had normal pituitary function. Disturbances in the gonadotropin function was detected in three patients and suspected in two. The mean insulin-like growth factor I (IGF-I) value of the patients was in the lower part of the reference range. In the patients with endocrine dysfunction, the 3D-CBF was pathologic in the central structures of the basal region. Conclusions - The present results indicate that an aneurysmal SAH may result in partially impaired pituitary capacity. This deficit may contribute to fatigue after aneurysmal SAH, but cannot solely explain this disorder. SPECT identified regional tissue damage in the patients with pituitary dysfunction after SAH.