Hormonstörungen nach erworbener Hirnschädigung

Zusammenfassung

Eine Hypophyseninsuffizienz ist kein seltenes Krankheitsbild und die Kenntnis ihrer Ursachen, Symptomatik und Diagnostik verdient die Beachtung des klinisch tätigen Neurologen. Neben der klassischen, durch hypophysär-hypothalamische Tumore ausgelösten Hypophyseninsuffizienz zeigen Arbeiten der letzten 10 Jahre, dass bei einer Reihe von Patienten mit einer Hirnschädigung (z. B. Schädel-Hirn-Trauma, aneurysmatische Subarachnoidalblutung, Spätfolgen einer Behandlung kindlicher Hirntumore) Störungen der zentralen endokrinen Sekretion auftreten können. Dieser Artikel stellt die klinische Symptomatik und Pathophysiologie der Hypophyseninsuffizienz sowie den Stand des Wissens zu neuroendokrinen Störungen bei den letztgenannten Krankheitsbildern beim Erwachsenen dar.

Abstract

Hypopituitarism is not a rare disease and its clinical signs and symptoms deserve the attention of the clinically practising neurologist. Next to the classical cause of hypopituitarism mediated by tumours of the hypothalamo-pituitary region, a number of recent articles have highlighted the high frequency of central endocrine disturbances in patients with brain damage, i. e. not only after traumatic brain injury and subarachnoid haemorrhage but also as a consequence of the treatment of childhood brain tumours. This article provides an overview of the clinical symptomatology and pathophysiology of hypopituitarism as well as the current knowledge about neuroendocrine disturbances in the adult patient suffering from the above-mentioned disorders.

Schlüsselwörter

Hypophyseninsuffizienz - Schädel-Hirn-Trauma - Subarachnoidalblutung - kraniale Bestrahlung - Hirntumor

Keywords

hypopituitarism - traumatic brain injury - subarachnoid haemorrhage - cranial irradiation - brain tumour

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