脳血管障害患者における下垂体ホルモン分泌能の検討

概要

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Anterior pituitary function was evaluated in 17 patients with cerebrovascular discase, i.e., 12 cases of intracranial aneurysm, 2 of arterio-venous malformation, 2 of traumatic carotid-cavernous fistula and l of idiopathic subarachnoid hemorrhage. Anterior pituitary function was assessed by plasma levels of GH and cortisol in ITT, of TSH and prolactin (PRL) in TRH test, of LH and FSH in LH-RH test. These examinations were performed between 2 and 60 days after the attack of subarachnoid hemorrhage or head injury and no drugs were administered that could interfere the test used. 1) GH, TSH, ACTH (cortisol), LH, FSH and PRL secretions were impaired in 23%, 35%, 6%, 6%, 6% and 0% of the cases respectively. However, these hyporeactive cases showed only slightly lower peak levels than the lower limit of the normal range. 2) Impaired TSH secretion were found only in patients with intracranial aneurysm, especially in the 4 patients with internal carotid artery aneurysm. 3) A patient who had a giant aneurysm at the internal carotid-ophthalmic portion, about 4.5 cm in the diameter, revealed the pattern of so-called hypothalamic hypopituitarism, that was elevated plasma levels of PRL and impaired secretion of other pituitary hormones.
日本脳神経外科学会の論文