[Hypothalamic and pituitary function in brain death]

Neurol Med Chir (Tokyo). 1991 Dec;31(13):881-6. doi: 10.2176/nmc.31.881.
[Article in Japanese]

Abstract

Hypothalamic and pituitary hormone levels were measured in 56 patients meeting the criteria of brain death proposed by the Japanese Ministry of Welfare. Pituitary hormone releasing tests were carried out in 39 patients. In addition, cerebral angiography and transcranial Doppler (TCD) were performed in 13 and six patients, respectively, just after hormone measurements. Serum hypothalamic and pituitary hormone levels were inconsistently high based on the half life time in the presumed absence of cerebral blood flow shown by angiography. The responses to releasing hormones were normal in 16 patients. TCD detected cerebral blood flow in the middle cerebral artery or ophthalmic artery in three patients who showed non-filling on angiography. Postmortem microscopic examination of the hypothalamus and anterior pituitary lobe revealed normal structure and cells intermingled with lytic changes and necrosis. This series suggests that some part of the hypothalamus and hypophysis may still be alive after brain death, although the function of these regions may be clinically insignificant.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Brain Death / diagnostic imaging
  • Brain Death / pathology
  • Brain Death / physiopathology*
  • Cerebral Angiography
  • Female
  • Gonadotropin-Releasing Hormone
  • Humans
  • Hypothalamic Hormones / metabolism
  • Hypothalamus / metabolism*
  • Hypothalamus / pathology
  • Male
  • Middle Aged
  • Pituitary Function Tests
  • Pituitary Gland / metabolism*
  • Pituitary Gland / pathology
  • Pituitary Hormones / metabolism
  • Thyrotropin-Releasing Hormone

Substances

  • Hypothalamic Hormones
  • Pituitary Hormones
  • Gonadotropin-Releasing Hormone
  • Thyrotropin-Releasing Hormone