Pituitary hormone level changes and hypxonatremia in aneurysmal subarachnoid hemorrhage

Maimaitili, Aisha; Mijiti, Maimaitili; Aikeremu, Rexidan; Lu, Jianwei; Ajimu, Kuerban; Xia, Cheng; Luo, Kun; Duishanbai, Sailike; Liu, Yuan; Kadeer, Kaheerman; Tang, Changjiu; Zhang, Tingrong

doi:10.3892/etm.2013.1068

Cited by 22 publications

(8 citation statements)

References 17 publications

(18 reference statements)

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“…These patients had a greater tendency for hormonal changes, and perhaps more significant damage to the hypothalamus-pituitary occurred, consequent to ischemia and increased intracranial pressure. 5 Our study found 52.4% of patients with changes in cortisol; the majority observed only after the test stimulation of insulin, when there was the expected increase in subsequent doses of 7μg/dl. A subarachnoid hemorrhage by rupture of cerebral aneurysm is the cause of psychological stress, as well as the stress or pain due to increased intracranial pressure.…”

Section: Discussionmentioning

confidence: 44%

Pituitary Hormonal Disturbances in Aneurysmal Subarachnoid Hemorrhage

Moura

Filho

Valença

et al. 2023

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

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Objective The objective of the present study was to assess the hormonal alterations that occurred in patients with subarachnoid hemorrhage. Methods This is a case series with 21 patients diagnosed with subarachnoid hemorrhage of aneurysmal etiology up to 30 days after the ictus. The following hormonal measurements were performed in these patients: cortisol, GH, testosterone, prolactin, estradiol, FSH, LH, FSH, T3, T4 and free T4. The hormonal results of the cases were compared with the results of twelve volunteers from the control group and correlated with findings in brain tomography, cerebral angiography, Hunt-Hess scale, and vasospasm. Results The main altered hormones were cortisol (52.6%), GH (42.9%) and TSH (28.6%). There was a trend towards more severe cases in the following groups of patients: Hunt-Hess scale > 2, Fisher scale > 1, aneurysmal topography in the anterior communicating artery and those who had vasospasm. Conclusion The present study observed the tendency of pituitary hormonal changes in patients with subarachnoid hemorrhage of aneurysmal etiology, corroborating the need for dosage of hormones from the hypothalamic-pituitary axis in the management of these cases.

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Section: Discussionmentioning

confidence: 44%

Pituitary Hormonal Disturbances in Aneurysmal Subarachnoid Hemorrhage

Moura

Filho

Valença

et al. 2023

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

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“…Trident pattern in pons area and peripheral fiber sparing is differential diagnosis with vasospasm, cerebral infarct and multiple sclerosis after non-aneurysmal perimesencephalic subarachnoid hemorrhage. 8) Aneurysm Y SIADH Saramma et al, 2013 16) Aneurysm Y CSW Hannon et al, 2012 5) Aneurysm Y SIADH Kubo et al, 2008 6) Aneurysm Y CSW Sherlock et al, 2006 17) Aneurysm Y SIADH Vrsajkov et al, 20121 9) Aneurysm Y CSW Nakagawa et al, 2010 12) Aneurysm Y CSW Wartenberg et al, 2006 20) Non-Aneurysm Y SIADH Chandy et al, 2006 3) Aneurysm Y CSW CSW: cerebral salt wasting; SIADH: Syndrome of inappropriate antidiuretic hormone secretion.…”

Section: Resultsmentioning

confidence: 99%

Central Pontine Myelinolysis After Non-Aneurysmal Perimesencephalic Subarachnoid Hemorrhage: Case Report and Review of the Literature

You

Han²,

Kim

et al. 2019

J Neurointensive Care

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Central pontine myelinolysis (CPM) is one of the encephalopathy that results from extreme fluctuations in serum sodium concentration and plasma osmolality. CPM after non aneurysmal perimesencephalic subarachnoid hemorrhage (NPSAH) is very rare. A 53-year-old female patient aggravated her instabilty 3 weeks after treatment of after NPSAH. Brain CT showed a prominent low-density lesion in the central pons. Vasospasm, pontine infarct, multiple sclerosis must be excluded after subarachnoid hemorrhage. Her brain magnetic resonance imaging (MRI) of the brainstem revealed CPM. The peripheral fiber sparing, central trident appearance was observed. Peripheral fiber sparing is more prominent, but central trident is disappearing at long-term follow-up MRI. CPM can develop even after NPSAH as well as aneurysmal subarachnoid hemorrhage. Trident pattern in pons area and peripheral fiber sparing is differential diagnosis with vasospasm, cerebral infarct and multiple sclerosis after NPSAH.

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“…Hyponatremia has also been reported to be associated with an increased risk of vasospasm. This may be the main reason for the poor prognosis of patients ( 18 ).…”

Section: Discussionmentioning

confidence: 99%

Characterizing Risk of In-Hospital Mortality Following Subarachnoid Hemorrhage Using Machine Learning: A Retrospective Study

Deng

2022

Front. Surg.

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BackgroundSubarachnoid hemorrhage has a high rate of disability and mortality, and the ability to use existing disease severity scores to estimate the risk of adverse outcomes is limited. Collect relevant information of patients during hospitalization to develop more accurate risk prediction models, using logistic regression (LR) and machine learning (ML) technologies, combined with biochemical information.MethodsPatient-level data were extracted from MIMIC-IV data. The primary outcome was in-hospital mortality. The models were trained and tested on a data set (ratio 70:30) including age and key past medical history. The recursive feature elimination (RFE) algorithm was used to screen the characteristic variables; then, the ML algorithm was used to analyze and establish the prediction model, and the validation set was used to further verify the effectiveness of the model.ResultOf the 1,787 patients included in the mimic database, a total of 379 died during hospitalization. Recursive feature abstraction (RFE) selected 20 variables. After simplification, we determined 10 features, including the Glasgow coma score (GCS), glucose, sodium, chloride, SPO2, bicarbonate, temperature, white blood cell (WBC), heparin use, and sepsis-related organ failure assessment (SOFA) score. The validation set and Delong test showed that the simplified RF model has a high AUC of 0.949, which is not significantly different from the best model. Furthermore, in the DCA curve, the simplified GBM model has relatively higher net benefits. In the subgroup analysis of non-traumatic subarachnoid hemorrhage, the simplified GBM model has a high AUC of 0.955 and relatively higher net benefits.ConclusionsML approaches significantly enhance predictive discrimination for mortality following subarachnoid hemorrhage compared to existing illness severity scores and LR. The discriminative ability of these ML models requires validation in external cohorts to establish generalizability.

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Pituitary hormone level changes and hypxonatremia in aneurysmal subarachnoid hemorrhage

Cited by 22 publications

References 17 publications

Pituitary Hormonal Disturbances in Aneurysmal Subarachnoid Hemorrhage

Pituitary Hormonal Disturbances in Aneurysmal Subarachnoid Hemorrhage

Central Pontine Myelinolysis After Non-Aneurysmal Perimesencephalic Subarachnoid Hemorrhage: Case Report and Review of the Literature

Characterizing Risk of In-Hospital Mortality Following Subarachnoid Hemorrhage Using Machine Learning: A Retrospective Study

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