Endocrine Abstracts

Introduction: Hypothalamo-pituitary dysfunction has been reported in patients after traumatic brain injury or subarachnoid hemorrhage with relatively high frequency according to published studies. Assessment of hypothalamo– pituitary functions in patients with chronic subdural hematomas has not been published yet, although dysfunction of hypothalamo- pituitary unit could be expected (head trauma, compression and oedema of the brain, shifting of the midline structures).

Aims: Evaluation of the pituitary functions in patients with chronic subdural hematoma immediately after surgical treatment and during one year follow-up.

Patients and methods: We have examined 59 patients (49 males, mean age 68.3 years, 36–88 years). Patients in the first days after evacuation of the hematoma and then 3 and 12 months after the operation were tested. Basal levels of pituitary hormones and hormones of dependent peripheral glands, plasma cortisol during 250 mcg ACTH test, GH after GHRH+arginine stimulation and TSH after TRH stimulation were assessed.

Results: Central hypogonadism was diagnosed in 13 patients (37%, n=35) in an acute phase, but in most of the cases had a transient character. GH deficiency was diagnosed according to the GHRH+arginine test in 25 patients (51%, n=49) in acute phase and according to the control tests 12 months after the operation was present in 18 patients

(37.5%, n=32). We did not find any serious case of hypocortisolism, hypothyroidism, nor diabetes insipidus centralis. Partial hypocortisolism was found in two cases, but has resolved according to the control tests. No relation between extension of SDH or clinical severity and development of hypopituitarism was observed.

Conclusions: There was GH deficiency or hypogonadism present in some patients in our cohort. No serious hypocortisolism, hypothyroidism, diabetes insipidus nor SIADH was observed. The possibility of hypothalamo-pituitary dysfunction should be considered in patients with subdural hematoma especially in those with history of trauma.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This work was supported, however funding details unavailable.