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Hyunwoo Do, Varun R Kshettry, Alan Siu, Irina Belinsky, Christopher J Farrell, Gurston Nyquist, Marc Rosen, James J Evans
OBJECTIVE: To assess outcomes after endoscopic endonasal surgery for recurrent or residual pituitary adenomas. METHODS: We retrospectively analyzed 61 patients from 2009 - 2016 that underwent endoscopic endonasal surgery for recurrent or residual pituitary adenomas after prior microscopic or endoscopic transphenoidal operation. RESULTS: Prior surgical approach was endoscopic endonasal in 55.7% and microscopic in 44.2%. The mean preoperative maximal tumor diameter was 2...
March 9, 2017: World Neurosurgery
Aurel Hasanbelliu, Norberto O Andaluz, Alberto Di Somma, Jeffrey T Keller, Lee Zimmer, Myles L Pensak, Ravi Samy, Mario Zuccarello
No abstract text is available yet for this article.
August 1, 2016: Neurosurgery
Tiffany Yeh, Angela Ganan Soto, Jose Bernardo Quintos, Lisa Swartz Topor
BACKGROUND: Turner syndrome (TS) is the most common sex chromosome abnormality in females, typically associated with primary amenorrhea and premature ovarian failure due to gonadal dysgenesis. The association of TS with hypopituitarism is an uncommon finding. The objective of the study was to describe an adolescent with TS with hypergonadotropic hypogonadism and subsequent hypogonadotropic hypogonadism. CASE PRESENTATION: A 16-year-old female with primary amenorrhea was diagnosed with TS based on karyotype 45,XO...
February 1, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
Erdem Atalay Cetinkaya, Koray Koc, Mehmet Fatih Kucuk, Pinar Koc, Nuray Bayar Muluk, Cemal Cingi
OBJECTIVES: Our objective was to analyze variations in the optic nerve (ON) course and surrounding structures in an effort to construct an optic nerve injury risk profile before endoscopic intranasal sphenoidal, or endoscopic endonasal transphenoidal, skull-base surgery, and eventually to construct and formulate a common classification by combining the known classes. The authors used computed tomography (CT) toward this end. METHODS: The authors retrospectively reviewed 200 consecutive CT scans (400 sides) of the paranasal sinuses...
January 2017: Journal of Craniofacial Surgery
Joshua Bakhsheshian, Diana L Jin, Ki-Eun Chang, Ben A Strickland, Dan A Donoho, Steven Cen, William J Mack, Frank Attenello, Eisha A Christian, Gabriel Zada
OBJECTIVE Patient demographic characteristics, hospital volume, and admission status have been shown to impact surgical outcomes of sellar region tumors in adults; however, the data available following the resection of craniopharyngiomas in the pediatric population remain limited. The authors sought to identify potential risk factors associated with outcomes following surgical management of pediatric craniopharyngiomas. METHODS The Nationwide Inpatient Sample database and Kids' Inpatient Database were analyzed to include admissions for pediatric patients (≤ 18 years) who underwent a transcranial or transsphenoidal craniotomy for resection of a craniopharyngioma...
December 2016: Neurosurgical Focus
Kevin Phan, Joshua Xu, Rajesh Reddy, Piyush Kalakoti, Anil Nanda, Jacob Fairhall
BACKGROUND: The pituitary adenoma causing acromegaly is typically resected through a transsphenoidal approach and visualized with an operating microscope or endoscope. We undertook a systematic review and meta-analysis examining the clinical efficacy of endoscopic and microsurgical approaches. METHODS: Relevant studies using either endoscopic or microscopic transsphenoidal approaches for growth hormone pituitary adenomas were identified until February 2016. Data were extracted and analyzed according to predefined clinical end points...
January 2017: World Neurosurgery
Jeffrey Wagner, Cara M Fleseriu, Aly Ibrahim, Justin S Cetas
BACKGROUND: Idiopathic intracranial hypertension (IIH) in patients with Cushing disease (CD), after treatment, is rarely described, in adults. The cause is believed to be multifactorial, potentially related to a relative decrease in cortisol after surgical resection or medical treatment of a corticotroph pituitary adenoma. We investigate our center's CD database (140 surgically and 60 medically [primary or adjunct] treated patients) for cases of IIH, describe our center's experience with symptomatic IIH, and review treatment strategies in adults with CD after transsphenoidal resection...
September 12, 2016: World Neurosurgery
Thinesh Kumran, Saffari Haspani, Jafri Malin Abdullah, Azmi Alias, Fan Rui Ven
BACKGROUND: To investigate factors influencing disconnection hyperprolactinemia, including tumour volume, degree of pituitary stalk displacement and extent of tumour growth based on a modified Wilson-Hardy classification in a non-functioning pituitary macroadenoma and to confirm reductions in serum prolactin levels after endoscopic transphenoidal surgery. METHODS: This prospective, descriptive study was conducted in the Department of Neurosurgery, General Hospital Kuala Lumpur from Jan 1, 2011 to Jan 1, 2013...
January 2016: Malaysian Journal of Medical Sciences: MJMS
Sasima Srisukh, Tananun Tanpaibule, Sasisopin Kiertiburanakul, Atthaporn Boongird, Duangkamon Wattanatranon, Theerapol Panyaping, Chutintorn Sriphrapradang
Pituitary tuberculoma is extremely rare, even in endemic regions of tuberculosis and much less frequently as a presentation of pituitary apoplexy. We describe a 25-year-old female presented with sudden onset of headache and vision loss of left eye which mimicking symptoms of pituitary apoplexy. MRI of the pituitary gland showed a rim-enhancing lesion at the intrasellar region extending into the suprasellar area, but absence of posterior bright spot with enhancement of the pituitary stalk. Pituitary hormonal evaluation revealed panhypopituitarism and diabetes insipidus...
2016: IDCases
Audrey E Arzamendi, Kiarash Shahlaie, Richard E Latchaw, Mirna Lechpammer, Hasmik Arzumanyan
OBJECTIVE: To describe the work-up and treatment of rare ectopic acromegaly caused by a biopsy-proven somatotroph pituitary adenoma located within the bony intersphenoid septum of a patient with empty sella syndrome (ESS). METHODS: We report the presentation, clinical course, diagnostic work-up, and lesion localization and treatment challenges encountered in a 55-year-old patient, with a brief review of relevant literature. RESULTS: A 55-year-old African-American man presented with acromegaly and ESS...
July 2016: Journal of Neurological Surgery Reports
Carly Grandidge, Andy Hall, Neil Kitchen
BACKGROUND: Pituitary carcinoma is defined by either metastases outside the central nervous system or noncontiguous foci within the central nervous system. This case report details the first documented case of a pathologically isolated follicle-stimulating hormone-secreting pituitary carcinoma and its presentation of metastasis. CASE DESCRIPTION: A 63-year-old man developed intrascapular pain radiating up his neck to his occiput. He had undergone a transsphenoidal hypophysectomy 2 years previously for an atypical pituitary macroadenoma...
September 2016: World Neurosurgery
Aurel Hasanbelliu, Norberto O Andaluz, Alberto Di Somma, Jeffrey T Keller, Lee Zimmer, Myles L Pensak, Ravi Samy, Mario Zuccarello
INTRODUCTION: Petroclival tumors and ventrolateral lesions of the pons present a unique surgical challenge. We aimed to provide qualitative and quantitative anatomic analyses of anterior petrous apicectomy through the transcranial middle fossa (TMF) and the extended endoscopic transphenoidal-transclival (EETT) approaches. METHODS: Ten cadaveric silicon-injected cadaver heads were used for this study. The petrous apex and the clivus were drilled extradurally through both middle fossa and endonasal approaches...
August 2016: Neurosurgery
Jennifer L Quon, Peter H Hwang, Michael S B Edwards
INTRODUCTION: Transnasal endoscopic transphenoidal approaches are an essential technique for the resection of skull base tumors in adults. Originally devised and most commonly used to treat pituitary adenomas, they have also been used for a variety of other pathologies. However, in the pediatric population, sellar and suprasellar lesions have historically involved a craniotomy. Transnasal endoscopic transphenoidal techniques in children have only been reported as single case reports and only in regard to purely sellar lesions...
August 2016: Neurosurgery
Jon E F Diernaes, Anette Bygum, Per L Poulsen
We present a patient with Cushing disease apparently suppressing sarcoidosis, which was unmasked following surgical resection of a pituitary adrenocorticotropin (ACTH)-producing microadenoma. Case report and a short review of the literature published in this area. A 46-year-old Caucasian woman presented with symptoms of hypercortisolism such as progressive weight gain, Cushingoid appearance, proximal myopathy, easy bruising, and amenorrhea. Blood testing including inferior petrosal sinus sampling uncovered an ACTH-producing microadenoma in the right aspect of the anterior pituitary gland for which the patient underwent transphenoidal resection...
January 2016: Dermato-endocrinology
Fergus Keane, Aoife M Egan, Patrick Navin, Francesca Brett, Michael C Dennedy
UNLABELLED: Pituitary apoplexy represents an uncommon endocrine emergency with potentially life-threatening consequences. Drug-induced pituitary apoplexy is a rare but important consideration when evaluating patients with this presentation. We describe an unusual case of a patient with a known pituitary macroadenoma presenting with acute-onset third nerve palsy and headache secondary to tumour enlargement and apoplexy. This followed gonadotropin-releasing hormone (GNRH) agonist therapy used to treat metastatic prostate carcinoma...
2016: Endocrinology, Diabetes & Metabolism Case Reports
Anand Alurkar, Lakshmi Sudha Prasanna Karanam, Sagar Oak, Smita Kori
Congenital absence of Internal Carotid Artery (ICA) is a rare anomaly seen in <0.01% of the population. Various collateral circulations develop in these cases to maintain adequate cerebral perfusion. High incidence of aneurysms is reported in these cases. Complete evaluation is required to detect other abnormalities usually seen in these patients. We report a case of congenital absence of right ICA in a 39-year-old female who presented with Subarachnoid Haemorrhage (SAH) and had a Middle Cerebral Artery Aneurysm (MCA)...
April 2016: Journal of Clinical and Diagnostic Research: JCDR
Olaide Ajayi, Vikram Chakravarthy, George Hanna, Kennethy DeLos Reyes
The endoscopic endonasal transphenoidal approach has proven to be a very versatile surgical approach for the resection of small midline skull base tumors. This is due to its minimally invasive nature, the potentially fewer neurological complications, and lower morbidity in comparison to traditional craniotomies. This surgical approach has been less commonly utilized for large midline tumors such as suprasellar germ cell tumors, due to numerous reasons including the surgeon's comfort with the surgical approach, a higher chance of postoperative cerebrospinal fluid (CSF) leak, limited visualization due to arterial/venous bleeding, and limited working space...
2016: Curēus
Faiza A Qari, Elaff A AbuDaood, Tariq A Nasser
OBJECTIVES: To review the incidence, spectrum of clinical manifestation, course, risk factors, as well as treatment of diabetes insipidus (DI) following neurosurgery of the pituitary gland. METHODS: The files of 24 patients that underwent neurosurgery for sellar lesions, or tumor near the hypothalamus or pituitary gland at the Department of Neurosurgery, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia were retrospectively reviewed between January 2011 to December 2014...
February 2016: Saudi Medical Journal
Chiara Maggioli, Paola Cambiaso, Sara Ciccone, Giovanna Stefania Colafati, Marco Cappa
Growth hormone (GH) secreting adenoma represents a therapeutic challenge in childhood. Because of its rarity no treatment guidelines are available and pediatric management often results from recommendations issued for adults. We report a case of a 4-year-old girl with somatotropinoma successfully treated with only medical treatment. She presented with tall stature and history of growth acceleration. Imaging and laboratory confirmed the diagnosis of GH secreting macroadenoma. She started medical treatment with a somatostatin analogue and a dopamine agonist...
April 2016: Journal of Pediatric Endocrinology & Metabolism: JPEM
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