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https://www.readbyqxmd.com/read/28449052/implementation-of-a-postoperative-outpatient-care-pathway-for-delayed-hyponatremia-following-transsphenoidal-surgery
#1
Michael A Bohl, Shahjehan Ahmad, William L White, Andrew S Little
BACKGROUND: After transsphenoidal surgery, delayed hyponatremia (DH) is the leading cause of 30-d unplanned hospital readmissions. OBJECTIVE: To determine the impact of a DH care pathway on 30-d readmissions after transsphenoidal surgery. METHODS: Data from before and after DH care pathway implementation were retrospectively reviewed. Patient demographics and clinical characteristics were compared. Readmission causes, clinical pathway failures, sodium trends, and symptoms were evaluated...
April 25, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28445162/binostril-endoscopic-transsphenoidal-neurosurgery-for-pituitary-adenomas-experience-with-42-patients
#2
Guan Sun, Ying Cao, Nan Jiang, Dekang Nie, Zhengqiang Wan, Min Li, Chiyuan Ma, Jun Guo
Here we review the technical aspects of our experience with the neuroendoscopic bilateral nostril (binostril) transsphenoidal approach for pituitary adenomas. A total of 42 patients were treated in our hospital from September 2013 to December 2015. Total tumor resection was completed in 31 cases, nearly full resection was achieved in 9 cases, and partial resection was achieved in 2 cases. In most cases clinical symptoms were relieved after surgery. These included 18/22 cases with visual field and vision disorders; 19/25 cases with headaches; 11/15 cases where high baseline PRL returned to normal levels; 6/7 cases where elevated blood GH returned to normal levels; and 2/3 cases where elevated blood ACTH returned to normal levels after surgery...
April 9, 2017: Oncotarget
https://www.readbyqxmd.com/read/28437813/presenting-symptoms-of-pituitary-apoplexy
#3
Efstratios-Stylianos Pyrgelis, Ioannis Mavridis, Maria Meliou
The classical term "pituitary apoplexy" (PA) describes a clinical syndrome usually characterized by abrupt onset of headache accompanied by neurologic and/or endocrinologic deterioration due to sudden expansion of a mass within the sella turcica as a result of hemorrhage or infarction within a pituitary tumor and adjacent pituitary gland. PA is a medical emergency and a difficult diagnosis to establish. Thus this article reviews the presenting symptoms of PA patients to help clinicians recognize or at least suspect this critical condition early on...
April 24, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28434959/analysis-of-137-patients-who-underwent-endoscopic-transsphenoidal-pituitary-adenoma-resection-under-high-field-intraoperative-magnetic-resonance-imaging-navigation
#4
Huaping Zhang, Fuyu Wang, Tao Zhou, Peng Wang, Xiaolei Chen, Jiashu Zahng, Dingbiao Zhou
OBJECTIVE: Endonasal resection of the pituitary embodies the minimally invasive concept. Pure endoscopic resection of pituitary adenoma has become the most popular surgical approach. Intraoperative magnetic resonance imaging (iMRI) systems have been in use for endoscopic resection of pituitary adenomas. The study aimed to evaluate the effectiveness of iMRI and neuroimaging navigation techniques during endoscopic endonasal transsphenoidal surgery of pituitary adenomas. METHODS: Data from 137 patients who underwent resection of endoscopic pituitary adenoma under 1...
April 18, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28434957/amygdalohippocampectomy-via-the-lateral-extended-transsphenoidal-endoscopic-approach-through-the-pterygopalatine-fossa-anatomic-study
#5
Pavel Kalinin, Oleg Sharipov, Maxim Kutin, Dmitry Fomichev, Andreis Gavrjushin, Georgiy Polev, Yevgeny Shults, Klementina Avdeeva
No abstract text is available yet for this article.
April 18, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28423663/a-novel-total-pituitary-hormone-index-as-an-indicator-of-postoperative-pituitary-function-in-patients-undergoing-resection-of-pituitary-adenomas
#6
Shousen Wang, Biao Li, Chenyu Ding, Deyong Xiao, Liangfeng Wei
The purpose of this study was to investigate the differences between pre- and postoperative pituitary hormone levels in patients undergoing surgical resection of pituitary adenoma and to identify factors associated with preoperative hypopituitarism.Data from 81 patients with histologically confirmed functioning and non-functioning pituitary adenomas (NFPA) who underwent transsphenoidal resection from January 2011 to December 2013 were retrospectively analyzed. Logistic regression was applied to analyze factors associated with preoperative hypopituitarism...
March 7, 2017: Oncotarget
https://www.readbyqxmd.com/read/28421822/deflation-of-a-rathke-cleft-cyst-triggered-rupture-of-a-superior-hypophyseal-artery-aneurysm-a-case-report
#7
Ryuheki Kitai, Takahiro Yamauchi, Yoshikazu Arai, Tetsuya Hosoda, Norichika Hashimoto, Kenzo Tsunetoshi, Yoshifumi Higashino, Ken-Ichiro Kikuta
A 57-year-old woman was diagnosed as a Rathke cleft cyst (RCC). Endoscopic transsphenoidal surgery (TSS) was performed uneventfully. She developed subarachnoid haemorrhage on postoperative day 3. The vessels adhered the cyst had been pulled into the pituitary fossa, causing an aneurysm.
April 19, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28420857/usefulness-of-anti-rabphilin-3a-antibodies-for-diagnosing-central-diabetes-insipidus-in-the-third-trimester-of-pregnancy
#8
Kanako Sakurai, Rika Yamashita, Satsuki Niituma, Shintaro Iwama, Yoshihisa Sugimura, Zenei Arihara, Kazuhiro Takahashi
We report a 27-year-old pregnant woman with polyuria, polydipsia and headache in the third trimester of pregnancy. Hypernatremia (153 mEq/L), high plasma osmolality (300 mOsm/kgH2O) and low urinary osmolality (92 mOsm/kgH2O) were observed at the admission to our hospital. Plasma arginine vasopressin (AVP) level was inappropriately low (2.2 pg/mL) compared to the high plasma osmolality. Plasma AVP responses to hypertonic-saline infusion were blunted, and her urine osmolality increased in response to desmopressin...
April 14, 2017: Endocrine Journal
https://www.readbyqxmd.com/read/28413523/predictors-of-visual-outcome-with-transsphenoidal-excision-of-pituitary-adenomas-having-suprasellar-extension-a-prospective-series-of-100-cases-and-brief-review-of-the-literature
#9
Amit Kumar Thotakura, Mohana Rao Patibandla, Manas K Panigrahi, Gokul Chowdary Addagada
OBJECTIVE: The aim was to assess the factors influencing the visual outcome following trans-sphenoidal excision of pituitary adenomas. MATERIALS AND METHODS: One hundred consecutive patients of pituitary adenomas with suprasellar extension (SSE) were operated by trans-sphenoidal approach from July 2003 to December 2006. There were 52 male and 48 female patients with a mean age of 42.47 years. The visual impairment score, which was used to evaluate the visual outcome was produced by adding the scores for visual acuity and visual field defects of each patient (from the tables of the German Ophthalmological Society)...
January 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28410953/spontaneous-cerebrospinal-fluid-fistula-in-the-clivus
#10
A Codina Aroca, J R Gras Cabrerizo, M De Juan Delago, H Massegur Solench
INTRODUCTION: Spontaneous cerebrospinal fluid (CSF) fistulas are infrequent and only 10 cases in the literature have been located in the clivus. We describe two new cases of CSF fistulas in this site and review the literature. CASE REPORT: The first patient was a 52-year-old woman referred to our centre for intermittent rhinorrhea that had been diagnosed after an episode of meningitis. The second case was a 69-year-old man who was visited for rhinorrhea of one-year duration; he also developed meningitis during the preoperative study...
April 11, 2017: European Annals of Otorhinolaryngology, Head and Neck Diseases
https://www.readbyqxmd.com/read/28409722/complete-endoscopic-resection-of-a-pituitary-stalk-epidermoid-cyst-using-a-combined-infrasellar-interpituitary-and-suprasellar-endonasal-approach-case-report
#11
Ana C I Nakassa, Joseph D Chabot, Carl H Snyderman, Eric W Wang, Paul A Gardner, Juan C Fernandez-Miranda
Intracranial epidermoid cysts are benign lesions of epithelial origin that most frequently present with symptoms of mass effect. Although they are often associated with a high rate of residual tumor and recurrence, maximal safe resection usually leads to good outcomes. The authors report a complete resection of an uncommon pituitary stalk epidermoid cyst with intrasellar extension using a combined suprasellar and infrasellar interpituitary, endoscopic endonasal transsphenoidal approach. The patient, a 54-year-old woman, presented with headache, visual disturbance, and diabetes insipidus...
April 14, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28403108/analyses-and-treatments-of-postoperative-nasal-complications-after-endonasal-transsphenoidal-resection-of-pituitary-neoplasms
#12
You Cheng, Fei Xue, Tian-You Wang, Jun-Feng Ji, Wei Chen, Zhi-Yi Wang, Li Xu, Chun-Hua Hang, Xin-Feng Liu
In this study, we analyze and discuss the treatments of postoperative nasal complications after endonasal transsphenoidal resection of pituitary neoplasms (PNs). We performed 129 endonasal transsphenoidal resections of PNs and analyzed and treated cases with nasal complications. After endonasal transsphenoidal resection of PNs, there were 26 cases of postoperative nasal complications (20.1%), including nasal hemorrhage (4.8%), cerebrospinal fluid rhinorrhea (6.9%), sphenoid sinusitis (2.3%), atrophic rhinitis (1...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28392496/preoperative-evaluation-of-the-interface-between-tuberculum-sellae-meningioma-and-the-optic-nerves-on-fast-imaging-with-steady-state-acquisition-for-extended-endoscopic-endonasal-transsphenoidal-surgery
#13
Yasuhiko Hayashi, Daisuke Kita, Issei Fukui, Yasuo Sasagawa, Masahiro Oishi, Osamu Tachibana, Fumiaki Ueda, Mitsutoshi Nakada
INTRODUCTION: Endoscopic endonasal transsphenoidal surgery (EETS) is increasingly applied to treat tuberculum sellae meningiomas. However, if the tumor adheres firmly to the optic nerve, dissection of the interface between both structures should be prudent to preserve visual function. The purpose of this study was to investigate whether tumor adhesion to the optic nerve can be predicted preoperatively by fast imaging with steady-state acquisition (FIESTA). METHODS: Twenty-two patients with tuberculum sellae meningioma treated with EETS were retrospectively identified...
April 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28389053/non-functioning-pituitary-adenoma-underwent-surgery-a-multicenter-retrospective-study-over-the-last-four-decades-1977-2015
#14
Pedro Iglesias, Karina Arcano, Vanessa Triviño, Paula García-Sancho, Juan José Díez, Fernando Cordido, Carles Villabona
OBJECTIVE: To assess clinical features, diagnostic procedures, therapies and outcomes in patients with clinically non-functioning pituitary adenomas (NFPAs) surgically treated over the last four decades. DESIGN AND METHODS: A multicenter retrospective study in NFPA patients periodically followed up in specialized neuroendocrinology units who underwent surgery in the period 1977-2015 was performed. RESULTS: A total of 131 patients were studied [66 women (50...
April 4, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28387628/endonasal-endoscopic-pituitary-surgery-in-the-elderly
#15
Peter J Wilson, Sacit B Omay, Ashutosh Kacker, Vijay K Anand, Theodore H Schwartz
OBJECTIVE Pituitary adenomas are benign, slow-growing tumors that cause symptoms either through mass effect or hormone overproduction. The decision to operate on a healthy young person is relatively straightforward. In the elderly population, however, the risks of complications may increase, rendering the decision more complex. Few studies have documented the risks of surgery using the endonasal endoscopic approach in a large number of elderly patients. The purpose of this study was to audit a single center's data regarding outcomes of purely endoscopic endonasal transsphenoidal resection of pituitary adenomas in elderly patients and to compare them to the current literature...
April 7, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28377801/current-best-practice-in-the-management-of-patients-after-pituitary-surgery
#16
REVIEW
Alessandro Prete, Salvatore Maria Corsello, Roberto Salvatori
Sellar and parasellar masses are a common finding, and most of them are treated surgically via transsphenoidal approach. This type of surgery has revolutionized the approach to several hypothalamic-pituitary diseases and is usually effective, and well-tolerated by the patient. However, given the complex anatomy and high density of glandular, neurological and vascular structures in a confined space, transsphenoidal surgery harbors a substantial risk of complications. Hypopituitarism is one of the most frequent sequelae, with central adrenal insufficiency being the deficit that requires a timely diagnosis and treatment...
March 2017: Therapeutic Advances in Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28368500/long-term-endocrine-outcomes-following-endoscopic-endonasal-transsphenoidal-surgery-for-acromegaly-and-associated-prognostic-factors
#17
Harish Babu, Alicia Ortega, Miriam Nuno, Aaron Dehghan, Aaron Schweitzer, H Vivien Bonert, John D Carmichael, Odelia Cooper, Shlomo Melmed, Adam N Mamelak
BACKGROUND: Long-term remission rates from endoscopic transsphenoidal surgery for acromegaly and their relationship to prognostic indicators of disease aggressiveness are not well documented. OBJECTIVE: To investigate long-term remission rates in patients with acromegaly after endoscopic transsphenoidal surgery, and correlate this with molecular and radiographic markers of disease aggressiveness. METHODS: We identified all patients undergoing endoscopic transsphenoidal surgery for acromegaly from 2005 to 2013 at Cedars-Sinai Pituitary Center...
March 29, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28363833/postoperative-neurosurgical-infection-rates-after-shared-resource-intraoperative-magnetic-resonance-imaging-a-single-center-experience-with-195-cases
#18
Nikolaj Dinevski, Johannes Sarnthein, Flavio Vasella, Jorn Fierstra, Athina Pangalu, David Holzmann, Luca Regli, Oliver Bozinov
OBJECTIVE: To determine the rate of surgical site infections (SSI) in neurosurgical procedures involving a shared-resource intraoperative magnetic resonance imaging (ioMRI) scanner at a single institution derived from a prospective clinical quality management database METHODS: All consecutive neurosurgical procedures that were performed with a high-field, two-room ioMRI between April 2013 and June 2016 were included (N=195; 109 craniotomies and 86 endoscopic transsphenoidal procedures)...
March 28, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28347892/transcranial-evacuation-of-atypical-progressive-supradiaphragmatic-hematoma-after-transsphenoidal-complete-resection-of-pituitary-adenoma
#19
Hussam Metwali, Rudolf Fahlbusch
OBJECTIVE: Supradiaphragmatic hematoma is a special type of hematomas after transsphenoidal resection (TS) of pituitary adenoma that required special management. METHODS: two patients suffered from symptomatic supradiaphragmatic hematomas after TS total resection of pituitary adenomas in the absence of vascular anomalies. Both patients also developed hydrocephalus at the time of diagnosis of the hematoma. The initial endoscopic endonasal inspection revealed the absence of subdiaphragmatic bleeding...
March 24, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28347678/one-and-a-half-syndrome-following-penetrating-head-injury-case-report
#20
Mathew R Voisin, Sanskriti Sasikumar, Jeremy H Russell, Gelareh Zadeh
The authors report a case of a 22-year-old otherwise healthy female who presented following a head injury during a bar altercation, with no associated loss of consciousness and an unknown mechanism of injury. Examination revealed an isolated 1cm laceration on the right upper eyelid, superior to her medial canthus. She experienced diplopia on right horizontal gaze due to a left internuclear ophthalmoplegia (INO) with an associated left conjugate horizontal gaze palsy, collectively described as a left one-and-a-half syndrome...
March 24, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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