Resumption of luteinizing hormone pulsatility and hypogonadotropic hypogonadism after endoscopic ventriculocisternostomy in a hydrocephalic patient

Objective: To study gonadotropin pulsatility before and after surgical cure of hydrocephalus. Design: Case report. Setting: Department of Endocrinology and Centre d'Investigations Cliniques, Necker Hospital, Paris, France. Patient(s): A 29-year-old woman who presented with secondary amenorrhea. Intervention(s): The patient underwent an endoscopic ventriculocisternostomy that led to restoration of normal menses and resolution of hypogonadism. Main Outcome Measure(s): A gonadotropin pulse study was performed before and 2 and 5 months after surgery. Result(s): No LH pulse was observed before surgery. Emergence of pulsatility was observed 2 months after surgery, and pulses became clearly individualized after 5 months. Conclusion(s): This observation strongly suggests that amenorrhea, in case of chronic hydrocephalus, is indeed due to a hypothalamic dysfunction of the GnRH pulse generator. (C) 2001 by American Society for Reproductive Medicine.