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Endocrine, neurosurgery, diabetes

Aoife Garrahy, Mark Sherlock, Christopher J Thompson
Advances in the management of traumatic brain injury, subarachnoid haemorrhage and intracranial tumours have led to improved survival rates and an increased focus on quality of life of survivors. Endocrine sequelae of the acute brain insult and subsequent neurosurgery, peri-operative fluid administration and/or cranial irradiation are now well described. Unrecognised acute hypopituitarism, particularly ACTH/cortisol deficiency and diabetes insipidus, can be life threatening. Although hypopituitarism may be transient, up to 30% of survivors of TBI have chronic hypopituitarism, which can diminish quality of life and hamper rehabilitation...
May 2017: European Journal of Endocrinology
J Marek
In pregnancy, the volume of pituitary increases by multiplication of lactotopic and gonadotropic cells and developing placenta is the source of numerous hormones and enzymes that significantly affect and alter the function of the endocrine system. This naturally has an impact on the course of pituitary disorders and their treatment. The most common disorders of pituitary gland, which we can meet in pregnancy, are adenomas, particularly prolactinomas, and functionless adenomas. During pregnancy we avoid the treatment of microprolactinomas, but in macroprolactinomas where there is the risk of their enlargement by stimulation of placental estrogens, we administer preventively the dopaminergic agonists...
June 2013: Vnitr̆ní Lékar̆ství
H J Schneider, S Rovere, G Corneli, C G Croce, V Gasco, R Rudà, S Grottoli, G K Stalla, R Soffietti, E Ghigo, G Aimaretti
OBJECTIVE: Hypopituitarism frequently follows pituitary neurosurgery (NS) and/or irradiation. However, the frequency of hypothalamic-pituitary dysfunction after NS of non-pituitary intracranial tumors is unclear. The aim of this study was to assess the presence of endocrine alterations in patients operated on for intracranial tumors. DESIGN: This is a retrospective study. METHODS: We studied 68 consecutive adult patients (28 female, 40 male, age 45...
October 2006: European Journal of Endocrinology
M Caldarelli, L Massimi, G Tamburrini, M Cappa, C Di Rocco
BACKGROUND: Craniopharyngioma (CP) is the most common intracranial non-glial tumour observed in pediatric age. Although histologically benign and amenable to surgical treatment, its location and relation with vital nervous and vascular structures makes the feasibility of a radical resection difficult even in the microneurosurgery era. Beside the difficulties experienced when performing tumour resection, post-operative complications, such as endocrinological imbalance, represent another point that makes CP total excision a challenge...
August 2005: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
P Matarazzo, L Genitori, R Lala, M Andreo, R Grossetti, C de Sanctis
Hydroelectrolytic disorders often complicate surgery of intra/parasellar tumors in children and adolescents. Eighteen patients undergoing microneurosurgical procedures for intra-supra-sellar craniopharyngioma (10 patients), hypothalamic germinomas (3 patients), hypothalamic-chiasmatic astrocytomas (3 patients), pituitary adenomas (2 patients) were studied. The hydroelectrolytic balance was assessed from 8 hours before surgery to 1 week after with a specific protocol in which water metabolism alterations were treated with standard procedure...
November 2004: Journal of Pediatric Endocrinology & Metabolism: JPEM
John L D Atkinson, Todd B Nippoldt
OBJECTIVE: To review the evolving approaches to surgical management of pituitary tumors during the past century, which may predict future directions. METHODS: We undertook a retrospective review of selected literature published during the past century and report the trends in the treatment of pituitary tumors. RESULTS: Harvey Cushing's extraordinary influence on American neurosurgery and remarkably successful pituitary surgical series were the foundation for the development of a highly subspecialized neurosurgical operative field...
September 2002: Endocrine Practice
N Hernandez Morin, D Huet, M Hautecouverture
We report here two cases of pituitary apoplexy or pseudoapoplexy revealing a gonadotroph adenoma. A 69-year-old man, who had just started antiandrogen treatment (Gn-RH agonist) for prostatic cancer, was admitted to neurosurgery emergency because of increasing headache and visual impairment. The CT-scan disclosed the presence of a large pituitary mass with lateral invasion of the left cavernous sinus. Hormonel testing showed panhypopituitarism. A few days later, diabetes insipidus appeared. The patient first received corticosteroid therapy and underwent surgical adenomectomy...
June 2003: Annales D'endocrinologie
J Honegger, M Buchfelder, R Fahlbusch
OBJECT: This study aimed to elucidate the endocrinological outcome of craniopharyngioma surgery. In particular, endocrinological results were analyzed in relation to the surgical approach. The study includes 143 patients who underwent pre- and postoperative endocrinological assessment and who had not previously undergone surgery. METHODS: Diabetes insipidus was the most common postoperative deficiency in both the transcranial and transsphenoidal groups. The overall percentage of patients with diabetes insipidus increased from 16...
February 1999: Journal of Neurosurgery
P Becker, D Schachter, E Gallardo, E Colin, J Selman, C Martínez
The clinical manifestations and the surgical treatment results of 280 patients (179 female), undergoing a total of 319 operations at the Asenjo Institute of Neurosurgery were retrospectively analyzed. The surgical approach for the first operation was transphenoidal in 89.3% of patients and transcraneal in the rest. Tumors were non-secretory in 169 (60.4%) patients, prolactinomas in 75 (27.8%) and produced acromegalia in 29 (10.4%) and Cushing syndrome in 7 (2.5%) patients. There was extraselar extension in 42% of women and 71% of men...
July 1994: Revista Médica de Chile
P J Nyberg
The pre- and postoperative endocrinological findings are evaluated in 128 patients suffering from pituitary adenoma without endocrine activity, undergoing surgery in the Department of Neurosurgery, University Hospital, Zürich, in the 10-year period between 1962 and 1971. The preoperative examination showed hypothyroidism in 24% of all cases. 59% of the males showed primary or secondary hypogonadism. All females in the age between puberty and menopause complained of menstrual disturbances. One patient complained of preoperative diabetes insipidus...
February 11, 1978: Schweizerische Medizinische Wochenschrift
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