Pituitary-adrenal function in patients with acute subarachnoid haemorrhage
Author Information
Author(s): Bendel Stepani, Koivisto Timo, Ruokonen Esko, Rinne Jaakko, Romppanen Jarkko, Vauhkonen Ilkka, Kiviniemi Vesa, Uusaro Ari
Primary Institution: Kuopio University Hospital
Hypothesis
The study aimed to characterize the behavior of serum adrenocorticotropic hormone (ACTH) and cortisol concentrations in patients with acute aneurysmal subarachnoid hemorrhage (SAH).
Conclusion
SAH severity did not affect cortisol concentrations, possibly indicating relative pituitary-adrenal insufficiency in patients with more severe bleeding.
Supporting Evidence
- Patients with SAH had higher initial serum total cortisol and free cortisol concentrations than control patients.
- ACTH concentrations were comparable between SAH and control groups.
- Patients with higher Hunt-Hess grades had higher ACTH concentrations.
Takeaway
When people have a type of brain bleed called subarachnoid hemorrhage, their bodies react by making more stress hormone, but this doesn't always mean their adrenal glands are working well.
Methodology
A prospective cohort study was conducted with patients having acute aneurysmal SAH and a control group undergoing elective surgery, measuring cortisol and ACTH levels over time.
Limitations
The study could not evaluate the period between one week and three months and had a limited number of patients with severe bleeding.
Participant Demographics
Patients aged 18 years and older with acute SAH and control patients scheduled for elective surgery.
Statistical Information
P-Value
0.001
Statistical Significance
p<0.001
Digital Object Identifier (DOI)
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