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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Serum LH, FSH and testosterone were quantitated in 9 patients with pure motor stroke within 24-48 h of its reported onset. High circulating LH with normal or low testosterone was noted in 8 of them. In response to an intravenous bolus of GnRH, the LH responses were exaggerated in all, but the FSH responses in 7 of them were comparable to those in eugonadal age matched controls. The rise in testosterone following 2000U hCG daily for 3 consecutive days was insignificant in the patients group compared to the controls. The data suggest normally operative pituitary testicular feed-back but decreased Leydig cell response in pure motor stroke.
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PMID:Circulating testosterone in pure motor stroke. 205 48

Fifty-one patients with CCT verified cerebral infarction were submitted to serum and CSF radioimmunoassay of FSH, LH, estradiol (E2), progesterone, testosterone, cortisol and T4. The results were compared to those of 82 matched controls. Our findings suggest that (1) high serum E2 is a risk factor of stroke in males; (2) low serum T4 is a risk factor in males; (3) serum testosterone is reduced in acute stroke in males confirming that it is stress sensitive; (4) serum LH was higher in hypertensive thrombotic males when compared to normotensive ones, and (5) FSH, LH, E2 and T4 are undetectable in CSF of patients and controls.
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PMID:Hormonal changes in cerebral infarction in the young and elderly. 224 31

To evaluate the effects of sex hormones on heart function and biochemistry, gonadectomy (GX) was performed in postpubertal male (M) and female (F) rats and compared with sham-operated controls (SH). The groups were MSH; MGX; MGX replaced with testosterone 3 mg/day s.c. (MGX + T), FSH, and FGX replaced with estrogen 2 mg/day (FGX + E), progesterone 0.4 mg/day (FGX + P), estrogen and progesterone (FGX + EP), or testosterone 2 mg/day (FGX + T). Body weight was decreased in MGX and was decreased further in MGX + T. Heart weight was decreased in both MGX and MGX + T. Body weights were increased in FGX and FTX + P and were increased further in FGX + T but were normal in FGX + E and FGX + EP. Heart weights were unchanged in F groups except in FGX + T, where it was increased. Cardiac performance in perfused hearts, as measured by stroke work, ejection fraction, fractional shortening and mean velocity of circumferential fiber shortening, was decreased in MGX but was slightly increased in MGX + T. Papillary muscle studies showed increases in time to peak tension and one-half relaxation in MGX, but these were decreased in MGX + T. Isotonic shortening studies showed decreased velocity of shortening in MGX and increased velocity in MGX + T. Heart function was significantly decreased in FGX and FGX + P compared with FSH but was similar to FSH in FGX + E and FGX + EP. FGX + T had greater stroke work and ejection fraction than FSH and FGX.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effects of gonadectomy and hormonal replacement on rat hearts. 295 49

In a comparative study the authors determined peripheral blood concentrations of immunoreactive testosterone, estradiol, LH, FSH, and prolactin in 32 males and 21 females, aged 60-74 years, with consequences of ischemic stroke, and in clinically normal elderly subjects. A control group was composed of healthy young people aged 20 to 35 years. It was found that in males and females with a history of stroke secretory insufficiency of the gonads and changes in the gonadotropic function of the pituitary expressed in a relative redistribution of gonadotropin fractions were significantly more pronounced than in normal age-matched subjects. The patients of both sexes exhibited a considerable elevation of blood prolactin levels. Hyperprolactinemia may either follow stroke since the latter impairs the hypothalamic regulation of prolactin secretion or precede it contributing to the development of a metabolic background conducive to the development of cerebral atherosclerosis.
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PMID:[Gonadal and gonadotropic function of late middle-aged men and women with sequelae of ischemic stroke]. 310 53

In a consecutive series of 51 one-stroke hemiplegics some aspects of sexuality were investigated using structured interviews. Findings were related to treatment with anti-hypertensive drugs. In most subjects the site of brain lesion was visualized by X-ray methods. Moreover, in a sub-sample of 15 consecutive males LH, FSH and prolactin were assessed using standard clinical radioimmunoassay techniques. Serum testosterone including response to HCG-stimulation was also measured. Both in males and females frequency of intercourse and durations of foreplay and of intercourse were markedly reduced. For the males erectile problems were rare before but occurred for the majority after stroke. For the females, but not for the males, orgastic dysfunction was relatively common pre-stroke. After the stroke such dysfunction occurred for 75% of the females and 64% of the males. Partnership sexual drive also decreased. Each of the 15 males hormonally screened had values within the predicted normal and responses to HCG-stimulation were also adequate. Moreover, actual levels of hormones were associated neither with change in sexual function nor with the sexual function per se at the time of the investigation. Thus, in this sample hormonal disarrangement did not appear to be the cause of sexual dysfunction. Surprisingly, no association between erectile dysfunction and use of anti-hypertensive drugs occurred. We believe that sexual dysfunctions in hemiplegics may rather be explained in terms of coping than by endocrine deficits or by anti-hypertensive treatment.
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PMID:Sexuality after stroke with hemiplegia. I. Aspects of sexual function. 686 36

A case of systemic lupus erythematosus (SLE) complicated with hypopituitarism after steroid pulse therapy is reported. A 46-years-old-female with a history of SLE starting in 1975 was admitted to our hospital in February 1991 for lupus nephritis. Steroid pulse therapy, 1000 mg methyl-prednisolone for 3 successive days as one therapy unit, was administered. Proteinuria improved remarkably, however, general fatigue and headache appeared 2 weeks after initiation of therapy. Endocrinological examination revealed hypopituitarism including the levels of TSH, FSH, GH and ACTH. The secretion of FSH and LH gradually improved after replacement therapy of dried thyroid. MRI examination of the brain revealed an empty sella. It is known that pituitary tumor, cerebrovascular accident and autoimmune lymphocytic hypophysitis cause hypopituitarism. In this case, it is unlikely that the pulse therapy may be responsible for the infarction of the anterior pituitary artery furthermore, there has been no articles describing such incidence after steroid pulse therapy. This case may be indicative of a very rare case in which the empty sella might have been exacerbated by the pulse therapy in the causation of hypopituitarism.
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PMID:[Hypopituitarism associated with empty sella after steroid pulse therapy in a patient with SLE]. 814 29

Pituitary apoplexy has been reported as a rare complication of combined tests and of TRH administration in prolactinomas. A 54-year-old man with a pituitary macroadenoma had a single injection of 100 micrograms GnRH. Twenty minutes later he complained of increasing headache and vomited. These symptoms settled spontaneously and were attributed to the pharmacological effects of GnRH. Five hours later he was found to be blind and disorientated without spontaneous complaint. Emergency CT showed a large adenoma with central necrosis, consistent with pituitary apoplexy. An urgent surgical decompression was carried out and necrotic haemorrhagic debris removed. Baseline bloods revealed non-pulsatile FSH of 40 U/l with LH 0.3 U/l with no hormonal response to GnRH administration, but the sequence of events strongly suggests a causal relationship between this and pituitary apoplexy. To our knowledge this is the first time that GnRH administration has been associated with pituitary apoplexy of a glycoprotein secreting pituitary adenoma.
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PMID:Pituitary apoplexy and sudden blindness following the administration of gonadotrophin releasing hormone. 782 63

Pregnancy occurring in patient with Sheehan's syndrome is seldom described. It depends on the preservation of LH and FSH secretion after the pituitary apoplexy event. PURPOSE--To report a patient with Sheehan's syndrome who became pregnant twice after the pituitary apoplexy episode and to discuss the maintenance of gonadotrophic function. METHOD--Clinical aspects are described and the pituitary reserve evaluation was performed as well as a computerized tomography and a magnetic resonance imaging of the brain. RESULTS--Gonadotrophic and thyrotrophic function were preserved and the neuroradiologic evaluation disclosed an empty sella turcica preservation of the posterior lobe of the hypophysis. CONCLUSION--A patient with Sheehan's syndrome is reported in whom the LH and FSH pituitary secretion was preserved allowing normal pregnancy twice after the pituitary apoplexy.
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PMID:[Preservation of gonadotrophic function and pregnancy in Sheehan's syndrome: a case report and review of the literature]. 852 May 95

Treatment of prostatic cancer with GnRH agonist is a medical alternative to surgical castration, although hyperstimulation of the tumor can occur. We describe an unusual unwanted effect of such a treatment which unmasked a clinically silent gonadotroph adenoma. A 62-year-old man developed after the first injection of leuprorelin-depot a sudden intracranial hypertension, which was related to apoplexy of an unknown pituitary adenoma. Its gonadotroph origin was recognized after surgery by immunocytochemistry. Retrospectively, the tumor was shown to secrete in vivo both FSH and LH when on therapy with the agonist, demonstrating the lack of desensitization. Testosterone levels were also markedly and sustainly high when on therapy, a particularly unwanted effect in prostatic cancer. As gonadotroph adenomas occur in men in the same age group as prostatic cancer, the question is raised whether hormonal testing and pituitary imaging should be performed before starting a therapy with GnRH agonist in men.
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PMID:Pituitary apoplexy of a gonadotroph adenoma following gonadotrophin releasing hormone agonist therapy for prostatic cancer. 941 12

A 42-year-old house wife presented with worsening headaches over 6 months in the absence of visual symptoms or symptoms suggestive of focal neurology. She was a life-long smoker. Systems review was unremarkable apart from secondary amenorrhoea and galactorrhoea of 6 months duration. Her serum prolactin was found to be 620 mU/l (60-400), FT4 12.6 nmol/l (9.8-23.1), TSH 1.38 mU/l (0.35-5.5), oestradiol < 73 pmol/l, LH and FSH of 4.4 and 12.6 mIU/l, respectively. She was on bromocriptine. A presumptive diagnosis of pneumonia, based on pyrexia and CXR findings, was made and she was started on IV antibiotics. Two days later she developed meningism and deterioration of conscious level. (Lumbar puncture results: no organisms, 312 neutrophils and 164 lymphocytes). CT scan revealed a 2.5-cm pituitary adenoma, with suprasellar extension. A repeat hormonal profile revealed FSH 1.4, LH < 0.3 mU/l, oestradiol < 73 pmol/l, prolactin 488 mU/l (60-400), and low random cortisol at 29 nmol/l. T1-weighted MRI revealed a large pituitary mass with evidence of haemorrhage. The patient subsequently underwent a transsphenoidal exploration with resection of the pituitary lesion. Whilst awaiting the histopathology results, CT of chest revealed a 1. 5-cm diameter rounded well defined density in the right lower lobe associated with hilar, pre- and right para-tracheal lymphadenopathy. The histopathology of the pituitary lesion, obtained piecemeal, revealed fragments of fibrous tissue infiltrated by sheets of acidophilic prolactin-positive cells, in keeping with a prolactinoma. In addition, other fragments with blood clot included highly atypical epithelial cells with mitotic figures. These were negative for prolactin but showed HMFG-and CEA-positivity, excluding them from a pituitary lineage. Transbronchial biopsy revealed moderately differentiated adenocarcinoma, with evidence of lymphatic spread. The overall conclusion was of bronchogenic adenocarcinoma, metastasizing to a prolactinoma and complicated by apoplexy.
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PMID:Pituitary apoplexy following metastasis of bronchogenic adenocarcinoma to a prolactinoma. 1046 19


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