Alterações endocrinológicas após hemorragia subaracnóidea

Resumo

A avaliação da função hipofisária na fase aguda ou tardia dos pacientes que sofrem hemorragia subaracnóidea (HSA) é infrequente; entretanto, a HSA apresenta um risco significante de disfunção pituitária, principalmente devido à vulnerabilidade da sua suplência vascular. Há poucos estudos tratando do tema, mas os existentes sugerem que distúrbios hormonais pós-hemorragia subaracnóidea são mais prevalentes do que inicialmente se suspeitava. Não somente a hipófise anterior parece estar envolvida nessas alterações; a hiponatremia no estágio agudo pode ser uma manifestação de disfunção da hipófise posterior. As alterações hormonais após HSA ainda recebem pouca atenção das equipes assistenciais, podendo ser uma das complicações potencialmente graves sendo tratável quando há suspeição pelo diagnóstico clínico e laboratorial.

Abstract

The evaluation of pituitary function in the acute and at late time in the patients with subarachnoid hemorrhage (SAH) is unusual. Meanwhile the SAH present with a high risc of pituitary disfunction primarily by the vulnerability of the vascular feeding vessels. Few studies about this subject suggest that hormonal disturbance are more prevalent that were suspected before. Both the anterior and posterior pituitary are involved. The hormonal changes after SAH are not well recognized by the physicians and can be treated even been a critical medical situation with clinical and laboratorial findings.

Palavras-Chave

aneurisma cerebral - hemorragia subaracnóidea - hipopituitarismo - deficiência do hormônio de crescimento - hipogonadismo - hipocortisolismo - diabete insípido

Keywords

brain aneurism - subarachnoid hemorrhage - hypopituitarism - hormone replacement therapy - hypogonadism - hypopituitarism - diabetes insipidus

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