AnÃlise dos distÃrbios hormonais na hemorragia subaracnÃidea, por ruptura de aneurisma intracraniano

AUTOR(ES)
DATA DE PUBLICAÇÃO

2004

RESUMO

Purpose: It is known that in severe head and brain trauma, hypothyroidism occurs. Some trials have assessed that these alterations also occur in subarachnoid hemorrhage caused by rupture of a brain aneurism. The present study has the purpose of assessing the hormone alterations that occurred in 21 subarachnoid hem orrhage patients as well as correlating such alterations to the severity of the hemorrhage, as analysed by the Hunt and Hess scale, with tomographic findings according to the Fisher scale, location of the brain aneurisms and the presence of brain vasospasm. Caseload e Methods: A prospective study was performed, with case series delineation in 21 patients with subarachnoid hemorrhage caused by brain aneurism rupture, in a period no longer than 30 days after the main event. Hormone assays were performed for T3, T4, TSH, free T4, FSH, LH, oestradiol, prolactin, testosterone, HGH and cortisol. An insulin tolerance test (ITT) was performed in every patient, to assess the cortisol and HGH reserve. The results were compared to the reference values of each test and confirmed by hormone assay in 12 healthy volunteers(control group). These results were correlated to the brain CAT scan, cerebral angiography and clinical assessment, based on the Hunt and Hess scale and presence or absence of vasospasm. A multivariate analysis with stratification was performed. Results: Hormone abnormalities with the following characteristics were found: Abnormal cortisol in 52,58% of cases; HGH in 42,85%; TSH in 28,57% of cases;T3 in 23,80%; free T4, LH and prolactin in 9,52%; FSH and T4 in 4,76% of cases. Four men had testosterone levels measured and it was abnormal in three of them(75%). We also verified that the sickest patients are more prone to abnormalities, those with Hunt and Hess ≥ 3, tomographic findings on Fisher scale ≥ 2, the presence of vasospasm and aneurisms located on the anterior comunicating artery. Conclusion: This study reveals the existence of hypothalamus-hypophisis axis hormone abnormalities in subarachnoid hemorrhages caused by rupture of a brain aneurism, justifying the studt of the hormone profile in all patients with this pathology

ASSUNTO(S)

hormone abnormalities aneurisma intracraniano intracranial aneurism neurologia hemorragia subaracnÃidea panhypopituitarism pan-hipopituitarismo alteraÃÃes hormonais subarachnoid hemorrhage

ACESSO AO ARTIGO

Documentos Relacionados