Parathyroid Hormone and Fatigue after Spontaneous Non-Aneurysmal Subarachnoid Hemorrhage

Abstract

Background: Spontaneous non-aneurysmal subarachnoid hemorrhage (NASAH) is debilitating, and survivors often complain of fatigue.  Fatigue and diffuse musculoskeletal pain are also common symptoms of elevated parathyroid hormone (PTH) levels. A possible  association between fatigue and PTH in subarachnoid hemorrhage (SAH) survivors has not yet been established. The aim was to study  the relation between PTH and fatigue after NASAH in a period over six months.

Methods: A single-center observational study was  conducted among 56 NASAH survivors and 60 healthy people as the control group. Fatigue was measured with the Arabic version of the  Chalder Fatigue Scale and its relationships with other clinical variables were examined.

Results: Among the enrolled NASAH survivors, 46  (82%) exhibited pathological fatigue one month after SAH and 33 (59%) enrolled patients exhibited pathological levels of fatigue at follow  up after six months of illness. PTH was significantly high in NASAH than in the control group. High PTH (>49 ng/L) is associated with an  increased risk of fatigue after SAH and was an independent risk factor of fatigue directly after SAH (P = 0.02).

Conclusion: In patients with  NASAH, fatigue worsened functional outcomes. An elevated serum PTH level may be an independent risk factor for fatigue after  NASAH.