Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 26, 2020; 8(22): 5773-5780
Published online Nov 26, 2020. doi: 10.12998/wjcc.v8.i22.5773
Amelioration of cognitive impairment following growth hormone replacement therapy: A case report and review of literature
Jung-Tung Liu, Pen-Hua Su
Jung-Tung Liu, Department of Neurosurgery, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
Jung-Tung Liu, Pen-Hua Su, Department of School of Medicine, Chung-Shan Medical University, Taichung 40201, Taiwan
Pen-Hua Su, Department of Pediatrics and Genetics, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
Author contributions: Liu JT was the neurosurgeon of the patient. Both the authors collected the patients’ clinical data, reviewed the literature, drafted and revised the manuscript, and approved the final version to be submitted.
Informed consent statement: Written informed consent was obtained from the patient before the publication of this report and accompanying images.
Conflict-of-interest statement:  The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Pen-Hua Su, MD, PhD, Professor, Department of Pediatrics and Genetics, Chung Shan Medical University Hospital, No. 110 Section 1, Jianguo North Road, South District, Taichung 40201, Taiwan. jen@csh.org.tw
Received: September 7, 2020
Peer-review started: September 7, 2020
First decision: September 23, 2020
Revised: September 30, 2020
Accepted: October 20, 2020
Article in press: October 20, 2020
Published online: November 26, 2020
Processing time: 79 Days and 12.8 Hours
Abstract
BACKGROUND

Stroke is one of the leading causes of death and disability worldwide. In patients suffering from strokes and other acute brain injuries, the prevalence of pituitary dysfunction is high, and growth hormone deficiency is commonly found. Previous studies have demonstrated that administration of recombinant human growth hormone provides adult growth hormone deficiency (AGHD) patients with beneficial effects such as improving body compositions and quality of life. Nevertheless, other physiological benefits of growth hormone substitution are still controversial and inconclusive.

CASE SUMMARY

A female with a history of hypertension suffered intracranial hemorrhage, intraventricular hemorrhage, and hydrocephalus at 56 years of age. Her mobility, fluency of speech, and mentality were impaired ever since the event occurred. After five years, the 61-year-old patient was further diagnosed with AGHD and received six-month growth hormone replacement therapy (GHRT). After six months of GHRT, the patient’s body composition was improved. A substantial improvement in Mini-Mental State Examination score was also observed, accompanying with ameliorations in mobility, fluency of speech, and mentality.

CONCLUSION

In addition to improvements in body composition, GHRT for AGHD may provide further beneficial effects in patients with cognitive or motor impairments due to intracerebral hemorrhage.

Keywords: Cerebral hemorrhage; Growth hormone; Cognitive dysfunction; Case report

Core Tip: We present a case report of a female patient suffered nontraumatic intracerebral hemorrhage and was diagnosed with adult growth hormone deficiency five years later. Unexpected improvements in cognitive function, fluency of speech, and mobility were observed after six months of growth hormone replacement therapy, suggesting that growth hormone replacement therapy may provide further beneficial effects in adult growth hormone deficiency patients with cognitive or motor impairments due to intracerebral hemorrhage.