{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:06:30Z","timestamp":1753891590617,"version":"3.41.2"},"reference-count":9,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,3,12]],"date-time":"2024-03-12T00:00:00Z","timestamp":1710201600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p>This report presents a case of a previously healthy 58\u2009years-old man who had suffered from persistent weakness and dizziness after a cerebellar intracranial hemorrhage (ICH). Endocrine function tests revealed low levels of plasma cortisol (3.05\u2009\u03bcg\/dL; normal range: 5\u201325\u2009\u03bcg\/dL) and adrenocorticotropic hormone (ACTH) (6.0\u2009pg\/mL; normal range: 10\u201360\u2009pg\/mL). The subsequent ACTH stimulation test suggested partial or recent hypopituitarism, resulting in adrenal gland atrophy and a subnormal cortisol response. Ultimately, the dizziness was found to be caused by undiagnosed adrenal insufficiency, which was detected when a hypotensive fainting incident occurred during rehabilitation. The symptoms improved significantly with oral prednisone supplementation. Notably, the duration of impaired hypothalamic-pituitary-adrenal axis may last as long as a year. This case highlights that adrenal insufficiency can easily be overlooked since its symptoms are similar to those commonly seen with cerebellar stroke alone. Physicians must be aware of the symptoms of adrenal insufficiency in patients with brain insults and conduct the appropriate endocrine tests to clarify the underlying comorbidity.<\/jats:p>","DOI":"10.3389\/fneur.2024.1332604","type":"journal-article","created":{"date-parts":[[2024,3,12]],"date-time":"2024-03-12T05:00:56Z","timestamp":1710219656000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Adrenal insufficiency following cerebellar intracranial hemorrhage: a case report"],"prefix":"10.3389","volume":"15","author":[{"given":"Yu-Yang","family":"Lu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chien-Ming","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shang-Lin","family":"Chiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,3,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1781","DOI":"10.1007\/s00134-017-4914-x","article-title":"Critical illness-related corticosteroid insufficiency (CIRCI): a narrative review from a Multispecialty Task Force of the Society of Critical Care Medicine (SCCM) and the European Society of Intensive Care Medicine (ESICM)","volume":"43","author":"Annane","year":"2017","journal-title":"Intensive Care Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1007\/s00134-014-3545-8","article-title":"Understanding the HPA response to critical illness: novel insights with clinical implications","volume":"41","author":"Boonen","year":"2015","journal-title":"Intensive Care Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1327","DOI":"10.1210\/clinem\/dgz206","article-title":"Dynamic pituitary-adrenal interactions in the critically ill after cardiac surgery","volume":"105","author":"Gibbison","year":"2020","journal-title":"J Clin Endocrinol Metabol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1937","DOI":"10.1097\/CCM.0b013e31817603ba","article-title":"Recommendations for the diagnosis and management of corticosteroid insufficiency in critically ill adult patients: consensus statements from an international task force by the American College of Critical Care Medicine","volume":"36","author":"Marik","year":"2008","journal-title":"Crit Care Med"},{"volume-title":"Diagnosis of adrenal insufficiency in adults","year":"2023","author":"Lynnette","key":"ref5"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"38","DOI":"10.7453\/gahmj.2013.008","article-title":"The CARE guidelines: consensus-based clinical case reporting guideline development","volume":"2","author":"Gagnier","year":"2013","journal-title":"Glob Adv Health Med"},{"volume-title":"Initial testing for adrenal insufficiency: Basal cortisol and the ACTH stimulation test","year":"2023","author":"Lynnette","key":"ref7"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1093\/bja\/aet077","article-title":"Dynamic output and control of the hypothalamic-pituitary-adrenal axis in critical illness and major surgery","volume":"111","author":"Gibbison","year":"2013","journal-title":"Br J Anaesth"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1477","DOI":"10.1056\/NEJMoa1214969","article-title":"Reduced cortisol metabolism during critical illness","volume":"368","author":"Boonen","year":"2013","journal-title":"N Engl J Med"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2024.1332604\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,12]],"date-time":"2024-03-12T05:00:59Z","timestamp":1710219659000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2024.1332604\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,12]]},"references-count":9,"alternative-id":["10.3389\/fneur.2024.1332604"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2024.1332604","relation":{},"ISSN":["1664-2295"],"issn-type":[{"type":"electronic","value":"1664-2295"}],"subject":[],"published":{"date-parts":[[2024,3,12]]},"article-number":"1332604"}}