Progression was defined as recurrence of completely resected or regrowth of residual NFA on CT or MRI. The occurrence of hormonal deficiencies was defined as the starting date of hormonal substitution therapy. Thyroid hormone and androgen deficiency were diagnosed by subnormal serum FT4 and testosterone levels, respectively. In premenopausal women, sex hormone deficiency was diagnosed by amenorrhea and low serum estradiol levels. In women aged above 50 years, as an indication of postmenopausal status, sex hormone deficiency was not classified. In women using estrogens/progestagens for contraceptive reasons, sex hormone deficiency was also not classified. Glucocorticoid deficiency was diagnosed by a low serum cortisol, by an insufficient serum cortisol response to insulin-induced hypoglycemia, or by an insufficient urinary tetrahydro compound S excretion with cut-off criteria as described elsewhere17,18. Pituitary function was checked at least twice annually. Growth hormone substitution was introduced in our clinic in the mid-nineties; growth hormone deficiency was not taken into account in the hormonal evaluation.
Cerebrovascular disease was defined as any transient or permanent cerebrovascular disorder.