Disfunción neuroendócrina secundaria a hemorragia subaracnoidea por ruptura de aneurisma. Revisión

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Raúl Carrillo Esper
Carlos Peñaherrera Oviedo
Luis Tamariz Amador

Abstract

La disfunción neuroendócrina es una complicación secundaria a lesión cerebral aguda que cursa con alteración del eje hipotálamo-hipofisario, por daño directo de origen vascular. Se caracteriza por la alteración de uno o varios de los sistemas hormonales regulados por la glándula pituitaria, llegando en casos graves al hipopituitarismo franco. Una de las causas más importantes de esta patología es la hemorragia subaracnoidea. El déficit hormonal aparece poco tiempo después de ocurrido el sangrado y puede persisitir a largo plazo, causando síntomas secundarios al nivel bajo de ciertas hormonas, y trastornos neuropsicológicos alterando en gran medida la calidad de vida de aquellos pacientes cuyo pronóstico funcional ya se encontraba alterado por la hemorragia en sí. El tratamiento con sustitución hormonal está indicado tanto en la fase aguda, como en la deficiencia permanente de cada hormona. A continuación se ofrece una actualización sobre el tema, con el fin de conocer mejor la enfermedad, cómo sospecharla, cuándo identificarla, y brindar el manejo adecuado.

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How to Cite
1.
Carrillo Esper R, Peñaherrera Oviedo C, Tamariz Amador L. Disfunción neuroendócrina secundaria a hemorragia subaracnoidea por ruptura de aneurisma. Revisión. Rev. Med. UCSG [Internet]. 2014 Oct. 27 [cited 2024 Nov. 22];18(2):109-16. Available from: https://editorial.ucsg.edu.ec/ojs-medicina/index.php/ucsg-medicina/article/view/587
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References

Barbosa J, Freitas L, Dellateri M, De Carvalho C, Vieira Jr G, Michelstaedter V, et al. Pituitary deficiency after aneurysmal subarachnoid hemorrhage. Clinics. 2013;68(6):745-749.

Wartenberg KE, Schmidt JM, Claassen J, Temes RE, Frontera JA, Ostapkovich N, et al. Impact of medical complications on outcome after subarachnoid hemorrhage. Crit Care Med. 2006 Mar;34(3):617-23.

Shin I, Joo H, Chung Y, Kim M, Park J, Ahn R. Abnormal diurnal pattern of cortisol secretion in patients after aneurysmal subarachnoid hemorrhage. Stress. 2011; 14(2): 156–165.

Kreitschmann-Andermahr I. Subarachnoid Hemorrhage as a Cause of Hypopituitarism. Pituitary 2005; 8: 219–225.

Schneider HJ, Kreitschmann-Andermahr I, Ghigo E, Stalla GK, Agha A. Hypothalamopituitary Dysfunction Following Traumatic Brain Injury and Aneurysmal Subarachnoid Hemorrhage: A Systematic Review. JAMA. 2007;298(12):1429-1438.

Kreitschmann-Andermahr I, Hoff C, Saller B, Niggemeier S, Pruemper S, Hütter BO, et al. Prevalence of Pituitary Deficiency in Patients after Aneurysmal Subarachnoid Hemorrhage. J Clin Endocrinol Metab 2004;89(10):4986-92.

Hannon MJ, Sherlock M, Thompson CJ. Pituitary dysfunction following traumatic brain injury or subarachnoid haemorrhage – In “Endocrine Management in the Intensive Care Unit”. Best Pract Res Clin Endocrinol Metab 2011;25(5):783-98.

Stevens RD, Nyquist PA. The systemic implications of aneurysmal subarachnoid hemorrhage. J Neurol Sci. 2007;261(1-2):143-56.

Tanriverdi F, Dagli AT, Karaca Z, Unluhizarci K, Selcuklu A, Casanueva FF, et al. High risk of pituitary dysfunction due to aneurismal subarachnoid haemorrhage: a prospective investigation of anterior pituitary function in the acute phase and 12 months after the event. Clin Endocrinol (Oxf). 2007;67(6):931-7.

Kelly DF, Gonzalo IT, Cohan P, Berman N, Swerdloff R, Wang C. Hypopituitarism following traumatic brain injury and aneurysmal subarachnoid hemorrhage: a preliminary report. J Neurosurg. 2000;93(5):743-52.

Zetterling M, Engström BE, Hallberg L, Hillered L, Enblad P, Karlsson T, et al. Cortisol and adrenocorticotropic hormone dynamics in the acute phase of subarachnoid haemorrhage. Br J Neurosurg. 2011;25(6):684-92.

Dimopoulou I, Kouyialis AT, Tzanella M, Armaganidis A, Thalassinos N, Sakas DE, et al. High Incidence of Neuroendocrine Dysfunction in Long-Term Survivors of Aneurysmal Subarachnoid Hemorrhage. Stroke. 2004;35(12):2884-9.

Bendel S, Koivisto T, Ruokonen E, Rinne J, Romppanen J, Vauhkonen I, et al. Pituitary-adrenal function in patients with acute subarachnoid haemorrhage: a prospective cohort study. Crit Care. 2008; 12(5): R126.

Melmed, S., Polonsky, K. S., Larsen, P. R., & Kronenberg, H. M. (2011). Pituitary Physiology and Diagnostic Evaluation. In: Williams textbook of endocrinology: Expert consult. 12th ed. Philadelphia: Elsevier; 2011.p. 175-211.

Osterman PO. Hypothalamo-pituitary-adrenal function following subarachnoid hemorrhage. Acta Neurol Scand. 1975;52(1):56-62.

Carrillo R, Castro J. Disfunción neuroendocrina en el enfermo neurocrítico. Med Int Mex 2009;25(4):270-7.

Bendel S, Koivisto T, Ryynänen O, Roukonen E, Romppanen J, Kiviniemi V, et al. Insulin like growth factor-I in acute subarachnoid hemorrhage: a prospective cohort study. Crit Care. 2010; 14(2): R75.

Aimaretti G, Ambrosio MR, Di Somma C, Gasperi M, Cannavo S, Scaroni C, et al. Residual Pituitary Function after Brain Injury-Induced Hypopituitarism: A Prospective 12-Month Study. J Clin Endocrinol Metab. 2005;90(11):6085-92.

Lammert A, Bode H, Hammes HP, Birck R, Fatar M, Zohsel K, et al. Neuro-Endocrine and Neuropsychological Outcome After Aneurysmal Subarachnoid Hemorrhage (aSAH): A Prospective Cohort Study. Exp Clin Endocrinol Diabetes 2011; 119(2):111-6.

Diringer MN. Neuroendocrine Regulation of Sodium and Volume Following Subarachnoid Haemorrhage. Clin Neuropharmacol 1995;18(2):114-26.

Poll EM, Boström A, Bürgel U, Reinges MH, Hans FJ, Gilsbach JM, et al. Cortisol Dynamics in the Acute Phase of Aneurysmal Subarachnoid Hemorrhage: Associations with Disease Severity and Outcome. J Neurotrauma. 2010;27(1):189-95.

Kreitschmann-Andermahr I, Poll EM, Reineke A, Langejürgen Y, Yagmur E, Gilsbach JM, et al. Diagnosing Neuroendocrine Dysfunction in Patients after Aneurysmal Subarachnoid Hemorrhage in Clinical Practice – Does Basal Hormone Screening Make Sense?. Exp Clin Endocrinol Diabetes 2008;116(5):276-81.

Schneider H, Stalla G, Bucfelder M. Expert meeting: hypopituitarism after traumatic brain injury and subarachnoid haemorrhage. Acta Neurochir (Wien) 2006;148(4):449-56.

Schneider H, Amaretti G, Kreitschmann-Andermahr I, Stalla G, Ghigo E. Hypopituitarism. Lancet. 2007; 369: 1461–70.

Urban RJ, Harris P, Masel B. Anterior hypopituitarism following traumatic brain injury. Brain Inj. 2005;19(5):349-58.