Division of Neurosurgery, David Geffen School of Medicine at UCLA, University of California, Room 6236A Ronald Reagan UCLA Medical Center, 750 Westwood Blvd, Los Angeles, CA 90095, USA.
Neurocrit Care. 2011 Sep;15(2):361-4. doi: 10.1007/s12028-011-9587-7.
Disruption of the hypothalamic-pituitary-adrenal axes may occur after aneurysmal subarachnoid hemorrhage, resulting in hypopituitarism. An electronic literature search was conducted to identify articles with English-language abstracts published between 1980 and March 2011, which addressed hypothalamic-pituitary-adrenal axis insufficiency and hormone replacement. A total of 18 observational and prospective, randomized studies were selected for this review. Limited data are available, evaluating pituitary effects during the acute stage after subarachnoid hemorrhage, with inconsistent results being reported. Overall, after acute subarachnoid hemorrhage, cortisol levels may initially be supranormal, decreasing toward normal levels over time. During the months to years after subarachnoid hemorrhage, pituitary deficiency may occur in one out of three patients. Limited data suggest modest outcome benefits with fludrocortisone and no benefit or harm from corticosteroids.
可能会发生在颅内动脉瘤性蛛网膜下腔出血后的下丘脑-垂体-肾上腺轴紊乱，导致垂体功能减退症。进行了电子文献检索，以确定 1980 年至 2011 年 3 月期间发表的英文摘要的文章，这些文章涉及下丘脑-垂体-肾上腺轴功能不全和激素替代治疗。总共选择了 18 项观察性和前瞻性随机研究进行综述。关于在蛛网膜下腔出血后急性期评估垂体作用的数据有限，报告结果不一致。总的来说，在急性蛛网膜下腔出血后，皮质醇水平最初可能高于正常水平，随着时间的推移逐渐降至正常水平。在蛛网膜下腔出血后的数月至数年内，三分之一的患者可能会发生垂体功能减退症。有限的数据表明，氟氢可的松有适度的预后益处，而皮质类固醇没有益处或危害。
