Hypothalamic and Pituitary Function in Brain Death

Hiroyuki YOKOTA, Shouzo NAKAZAWA, Toshirou SHIMURA, Akio KIMURA, Yasuhiro YAMAMOTO, Toshibumi OTSUKA
1991 Neurologia medico-chirurgica  
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 hypotha lamic and pituitary hormone levels were inconsistently high based on the half life time in the pre sumed absence
more » ... 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 microscop ic 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 hypothala mus and hypophysis may still be alive after brain death, although the function of these regions may be clinically insignificant.
doi:10.2176/nmc.31.881 pmid:1726247 fatcat:s2od2jzt3zc6niecb5a2ln4xwa