• World Neurosurg · Apr 2016

    Clinical Trial

    Reduced Quality of Life in Patients with Pituitary Dysfunction after Aneurysmal Subarachnoid Hemorrhage: A Prospective Longitudinal Study.

    • Erik Kronvall, Bengt Sonesson, Stig Valdemarsson, Roger Siemund, Hans Säveland, and Ola G Nilsson.
    • Division of Neurosurgery, Department of Clinical Sciences, Lund University, Lund, Sweden. Electronic address: erik.kronvall@med.lu.se.
    • World Neurosurg. 2016 Apr 1; 88: 83-91.

    ObjectivePituitary dysfunction (PD) after aneurysmal subarachnoid hemorrhage (SAH) has been demonstrated in several studies. Given the similarities between psychological symptoms and reduced quality of life (QoL) in patients with PD and fatigue commonly seen in patients after SAH, we investigated the relationship between QoL and PD after SAH.MethodsThere were 51 patients with aneurysmal SAH prospectively recruited and evaluated for health-related QoL using the Psychological General Well-Being Index. Evaluations were conducted 3-6 months (n = 45), 6-12 months (n = 44), and 12-24 months (n = 44) after SAH, with concomitant assessment of endocrine function. The study protocol also included a magnetic resonance imaging examination 3 months after SAH.ResultsMean general well-being scores showed a positive trend from 97.3 at 3-6 months to 104.3 at 12-24 months for all patients. Multiple regression analysis identified age, sex, Hunt and Hess grade, and PD as independent predictors for general well-being. Patients with PD had significantly lower scores compared with patients with normal pituitary function at 3-6 months (85.4 vs. 101.7) and 6-12 months (90.4 vs. 105.3). This result was due to central hypoadrenalism (score 81.6 at 3-6 months and score 82.2 at 6-12 months) but not other types of PD. The extent of magnetic resonance imaging lesions had a significant negative correlation to Glasgow Outcome Scale score at all follow-up evaluations. All patients with hypothalamic magnetic resonance imaging lesions had evidence of PD at some point during the follow-up period.ConclusionsThe results support PD, and central hypoadrenalism in particular, as a contributing factor for impaired health-related QoL in patients after SAH.Copyright © 2016 Elsevier Inc. All rights reserved.

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