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https://www.readbyqxmd.com/read/28875121/spontaneous-cerebrospinal-fluid-rhinorrhea-association-with-body-weight-and-imaging-data
#1
Raphaële Quatre, Arnaud Attye, Christian Adrien Righini, Emile Reyt, Joris Giai, Sébastien Schmerber, Alexandre Karkas
Objective  Spontaneous cerebrospinal fluid rhinorrhea (SCSFR) might be the only clinical manifestation of idiopathic intracranial hypertension (IIH), which has been historically related to overweight. Our goal was to search for an association between SCSFR and increased body weight on the one hand and SCSFR and imaging findings suggestive of IIH on the other hand. Materials and Methods  We retrospectively collected clinical and radiological data of patients operated on endoscopically for SCSFR in our institution from 1993 to 2013...
October 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28843758/new-technique-for-chiasmapexy-using-iliac-crest-bone-graft-two-cases-of-visual-impairment-caused-by-empty-sella-syndrome
#2
Atsushi Tsukiyama, Yujiro Hattori, Shigeyuki Tahara, Eitaro Ishisaka, Daijiro Morimoto, Kenichi Oyama, Akira Teramoto, Akio Morita
BACKGROUND: Chiasmapexy is used to treat empty sella syndrome, and various materials are used for the elevation of the optic chiasm. However, the use of artificial substances may have the risk of graft infection, and fat and muscle may be absorbed over the long term after surgery. In addition, bone and cartilage may be unavailable in adequate amounts. Here, we describe a new technique for chiasmapexy using an iliac crest bone graft. CASE DESCRIPTION: The first patient was a 71-year-old woman who had undergone transsphenoidal surgery twice for the treatment of pituitary adenoma and Rathke's cleft cyst...
August 23, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28780516/diagnosis-of-endocrine-disease-primary-empty-sella-a-comprehensive-review
#3
Sabrina Chiloiro, Antonella Giampietro, Antonio Bianchi, Tommaso Tartaglione, Antonio Capobianco, Carmelo Anile, Laura De Marinis
Primary empty sella (PES) is characterized by the herniation of the subarachnoid space within the sella, which is often associated with variable degree of flattening of the pituitary gland in patients without previous pituitary pathologies. PES pathogenetic mechanism are not well known but seem due to a sellar diaphragm incompetence, associated to the occurrence of upper sellar or pituitary factors, as intracranial hypertension and change of pituitary volume. As PES represents in majority of cases a neuroradiological findings, without any clinical implication, the occurrence of endocrine, neurological and opthalmological symptoms, due to the above describes anatomical alteration, delineates the so called PES syndrome...
August 5, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28642181/surgical-outcome-of-growth-hormone-secreting-pituitary-adenoma-with-empty-sella-using-a-new-classification
#4
Qiang Wang, Xiaopeng Guo, Lu Gao, Zihao Wang, Kan Deng, Wei Lian, Renzhi Wang, Huijuan Zhu, Bing Xing
OBJECTIVE: To investigate outcomes and identified risk factors affecting cure and intraoperative cerebrospinal fluid leak after transsphenoidal surgery using a new classification for growth hormone-secreting pituitary adenoma associated with empty sella. METHODS: In this retrospective cohort study, 51 patients enrolled from January 2010 to June 2016 were categorized into 3 groups using a new classification scheme: grade A, whole tumor occupation area beneath a horizontal line drawn along the lowest level of empty sella; grade B, tumor occupation area that crossed the horizontal line on 1 side; and grade C, tumor occupation area that crossed the horizontal line on 2 sides...
September 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28607780/homonymous-superior-quadrantanopia-due-to-erdheim-chester-disease-with-asymptomatic-pituitary-involvement
#5
Roaa Ridha Amer, Sara Mohammed Qubaiban, Eman Abdulkarim Bakhsh
Polyostotic sclerosing histiocytosis, also known as Erdheim-Chester disease (ECD), is a rare form of non-Langerhans histiocytosis. ECD has wide clinical spectrums which mainly affect skeletal, neurological, dermatological, retroperitoneal, cardiac, and pulmonary manifestations. Here we describe a case of ECD in a 45-year-old female who presented initially with bilateral knee pain and homonymous superior quadrantanopia progressed to ophthalmoplegia and complete visual loss of the left eye over a period of one year...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28587427/mri-features-of-growth-hormone-deficiency-in-children-with-short-stature-caused-by-pituitary-lesions
#6
Chao Xu, Xinxian Zhang, Lina Dong, Bin Zhu, Tao Xin
We verified the advantages of using magnetic resonance imaging (MRI) for improving the diagnostic quality of growth hormone deficiency (GHD) in children with short stature caused by pituitary lesions. Clinical data obtained from 577 GHD patients with short stature caused by pituitary lesions were retrospectively analyzed. There were 354 cases (61.3%) with anterior pituitary dysplasia; 45 cases (7.8%) of pituitary stalk interruption syndrome (PSIS); 15 cases (2.6%) of pituitary hyperplasia due to primary hypothyroidism; 38 cases (6...
June 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28552871/a-case-of-stiff-person-syndrome-due-to-secondary-adrenal-insufficiency
#7
Yuri Mizuno, Hiroo Yamaguchi, Taira Uehara, Kenichiro Yamashita, Ryo Yamasaki, Jun-Ichi Kira
We report a case of flexion contractures in a patient's legs secondary to postpartum hypopituitarism. A 56-year-old woman presented with a 3-year history of worsening flexion contractures of the hips and knees. On admission, her hips and knees could not be extended, and she had muscle stiffness and tenderness to palpation of the lower extremities. We first suspected stiff-person syndrome or Isaacs' syndrome because of her muscle stiffness. However, multiple hormones did not respond to stimulation tests, and an MRI of the brain showed atrophy of the pituitary gland with an empty sella...
June 28, 2017: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/28521183/predictors-of-poor-visual-outcome-in-patients-with-idiopathic-intracranial-hypertension-iih-an-ambispective-cohort-study
#8
Amit Agarwal, Deepti Vibha, Kameshwar Prasad, Rohit Bhatia, Mamta Bhushan Singh, Ajay Garg, Rohit Saxena
OBJECTIVE: Idiopathic intracranial hypertension (IIH) is a disease of young with threat to vision if not diagnosed timely. This study looked at the putative predictors of poor visual outcome in patients with IIH at six months after presentation via a cohort study. PATIENTS AND METHODS: All patients diagnosed with IIH from January 2011 to May 2015 were enrolled. The study design was ambispective cohort study. The baseline clinical and radiological characteristics assessed were age, sex, body mass index (BMI), duration of symptoms, transient visual obscuration, cranial nerve palsy, diminution of vision, Cerebrospinal fluid (CSF) opening pressure, empty sella, optic nerve dilatation, global configuration and transverse sinus stenosis...
May 10, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28469923/macroprolactinoma-appearing-after-resolution-of-hydrocephalus
#9
Oscar D Bruno, Ricardo Fernández Pisani, Gabriel Isaac, Armando Basso
SUMMARY: The role of mechanical forces influencing the growth of a pituitary adenoma is poorly understood. In this paper we report the case of a young man with hyperprolactinaemia and an empty sella secondary to hydrocephalia, who developed a macroprolactinoma following the relief of high intraventricular pressure. LEARNING POINTS: The volume of a pituitary tumour may be influenced not only by molecular but also by local mechanical factors.Intratumoural pressure, resistance of the sellar diaphragm and intracranial liquid pressure may play a role in the final size of a pituitary adenoma...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28430293/three-cases-of-ectopic-sphenoid-sinus-pituitary-adenoma
#10
Ernest Jan Bobeff, Karol Wiśniewski, Wielisław Papierz, Ludomir Stefańczyk, Dariusz Jan Jaskólski
<i><b>Introduction</b>: Ectopic sphenoid sinus pituitary adenoma is a rare tumour originating from embryologic remnants of Rathke's pouch. Although it is considered a clinically benign neoplasm, necrosis is encountered in 25% of cases and it can invade adjacent bone structures. <b>Aims</b>: To establish clinical, radiological and histopathological features of ectopic sphenoid sinus pituitary adenoma. <b>Material and methods: </b> Analysis of three cases: two females and one man, aged 61-70...
2017: Folia Neuropathologica
https://www.readbyqxmd.com/read/28355719/-a-clinical-analysis-of-123-cases-of-primary-empty-sella
#11
J Li, H W Jia, C L Wang, R Zhang, M Y Qu, W Li, M H Yuan, J Cui, Q He, H Y Wei, T H Zhu, Z S Ma, W Liu, Z L Dong, Z G Gao
Objective: This study was conducted to analyze the clinical characteristics and pituitary function of patients with primary empty sella (PES). Methods: The clinical data from 123 hospitalized adult patients with PES from January 2010 to May 2016 were retrospectively studied. Results: (1) The average age of the 123 (male 43, female 80) PES patients was (59.2±13.6) years (ranging 24-92 years), among whom 61% patients were in the age group between 50-69 years. (2) The symptoms of the patients included fatigue (56...
April 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/28349763/radiographic-evidence-of-occult-intracranial-hypertension-in-patients-with-m%C3%A3-ni%C3%A3-re-s-disease
#12
COMPARATIVE STUDY
Kareem O Tawfik, Shawn M Stevens, David Mihal, Mark S Costello, Rebecca S Cornelius, Ravi N Samy, Myles L Pensak
Objectives (1) Describe the prevalence of radiographic signs of intracranial hypertension (ICH) in Ménière's disease (MD) and (2) compare the prevalence of radiographic signs of ICH in MD patients managed medically to those managed surgically. Study Design Case-control study. Setting Academic neurotologic practice. Subjects and Methods Adult MD patients (aged ≥17 years) treated from 2011 to 2015 were reviewed. Inclusion required magnetic resonance imaging (MRI) of the head and follow-up >6 months. Patients with intracranial tumors, mass effect, trauma, previous intracranial surgery, and glaucoma were excluded...
August 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28349571/idiopathic-intracranial-hypertension-contemporary-review-and-implications-for-the-otolaryngologist
#13
Shawn M Stevens, Habib G Rizk, Karl Golnik, Norberto Andaluz, Ravi N Samy, Ted A Meyer, Paul R Lambert
OBJECTIVES: 1) Review controversies pertaining to the pathophysiology, diagnosis, and treatment of idiopathic intracranial hypertension. 2) Discuss the evolving role of otolaryngologists in managing this disease and related disorders. DATA SOURCES: Primary literature review, Centers for Disease Control and Prevention website, International Classification of Headache Disorders, Second Edition. METHODS: A comprehensive review of the primary literature was performed from 1990 to 2016 utilizing keywords idiopathic intracranial hypertension, pseudotumor cerebri, benign intracranial hypertension, spontaneous cerebrospinal fluid leak, and encephalocele...
March 27, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28263215/pituitary-adenoma-recurrence-suspected-on-central-hyperthyroidism-despite-empty-sella-and-confirmed-by-68ga-dota-toc-pet-ct
#14
Mathieu Gauthé, Julie Sarfati, Nathalie Bourcigaux, Sophie Christin-Maitre, Jean-Noël Talbot, Françoise Montravers
Thyrotropin-secreting pituitary adenomas are very rare tumors, known to present overexpression of somatostatin receptor subtype 2 and which may consequently demonstrate abnormal uptake on Ga-DOTA-TOC PET/CT. A 67-year-old woman with a history of operated pituitary macroadenoma presented with symptoms of hyperthyroidism including a large goiter. Her serum thyroid hormone levels were in favor of central hyperthyroidism. Pituitary MRI depicted an empty sella but visualized an ambiguous lesion centered on the left sphenoidal sinus...
June 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28195748/imaging-features-of-idiopathic-intracranial-hypertension-in-children
#15
Alexander J P W Hartmann, Bruno P Soares, Beau B Bruce, Amit M Saindane, Nancy J Newman, Valérie Biousse, Jason H Peragallo
Magnetic resonance imaging (MRI) signs of elevated intracranial pressure and idiopathic intracranial hypertension have been well characterized in adults but not in children. The MRIs of 50 children with idiopathic intracranial hypertension and 46 adults with idiopathic intracranial hypertension were reviewed for optic nerve head protrusion, optic nerve head enhancement, posterior scleral flattening, increased perioptic cerebrospinal fluid, optic nerve tortuosity, empty or partially empty sella, tonsillar herniation, enlargement of Meckel's cave meningoceles, and transverse venous sinus stenosis(TSS)...
January 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/28129900/-atypical-and-rare-cardiac-revelation-about-sheehan-s-syndrome-a-report-of-three-cases
#16
N Bouznad, G El Mghari, M El Hattaoui, N El Ansari
Sheehan syndrome is a potentially serious complication in the postpartum period corresponding to ischemic necrosis of the anterior pituitary related to postpartum haemorrhage. We report three original observations showing an unusual mode of revelation of this syndrome. The first observation is that of a 46-year-old patient admitted initially to resuscitation for a recovered cardiorespiratory arrest, severe hypoglycemia and profound hyponatremia. The second is that of a 45-year-old patient, admitted for recurrent cardiac tamponade after pericardial and pleural puncture and pericardial drainage; clinical survey found signs of slight panhypopituitarism...
January 24, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/28089836/delayed-cerebrospinal-fluid-rhinorrhea-after-gamma-knife-radiosurgery-with-or-without-preceding-transsphenoidal-resection-for-pituitary-pathology
#17
Avital Perry, Christopher S Graffeo, William R Copeland, Kathryn M Van Abel, Matthew L Carlson, Bruce E Pollock, Michael J Link
BACKGROUND: Skull base cerebrospinal fluid (CSF) leak after gamma knife radiosurgery (GKRS) is a very rare complication. In patients who were treated with both GKRS and transsphenoidal resection (TSR) for pituitary lesions, early CSF leak occurs at a comparable rate with the general TSR population (4%). Delayed CSF leak occurring more than a year after TSR, GKRS, or dual therapy is exceedingly rare. METHODS: Retrospective chart review and review of the literature...
April 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28018694/anterior-hypopituitarism-and-treatment-response-in-hunter-syndrome-a-comparison-of-two-patients
#18
Munier A Nour, Paola Luca, David Stephure, Xing-Chang Wei, Aneal Khan
Hypopituitarism is a clinically important diagnosis and has not previously been reported in Hunter syndrome. We contrast two cases with anatomic pituitary anomalies: one with anterior panhypopituitarism and the other with intact pituitary function. Patient 1, a 10-year-old boy with Hunter syndrome, was evaluated for poor growth and an ectopic posterior pituitary gland. Endocrine testing revealed growth hormone (GH) deficiency, secondary adrenal insufficiency, and tertiary hypothyroidism. An improvement in growth velocity with hormone replacement (GH, thyroxine, and corticosteroid) was seen; however, final adult height remained compromised...
2016: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/27967223/visual-vignette
#19
Jeyakantha Ratnasingam, Kheng Chiew Chooi, Syahrizan Samsuddin, Sharmila Paramasivam, Luqman Ibrahim, Lee Ling Lim, Alexander Tan, Shireene Vethakkan
No abstract text is available yet for this article.
June 2017: Endocrine Practice
https://www.readbyqxmd.com/read/27918153/enlargement-of-meckel-s-cave-in-patients-with-spontaneous-cerebrospinal-fluid-leaks
#20
Geoffrey P Aaron, Elisa Illing, Zachary Lambertsen, Miles Ritter, Erik H Middlebrooks, Joel Cure, Do-Yeon Cho, Kristen O Riley, Bradford A Woodworth
BACKGROUND: Spontaneous cerebrospinal fluid (CSF) leaks have imaging findings consistent with chronically elevated intracranial pressure, such as empty sella. Meckel's cave is a CSF-filled space that houses the trigeminal ganglion at the cranial base. Our objective in this study was to evaluate "dilated" Meckel's cave as a radiologic sign in patients with elevated intracranial pressure spontaneous CSF leaks and compare the dimensions with those from a control cohort. METHODS: Meckel's cave dimensions were measured in patients with spontaneous CSF leaks and documented elevated intracranial pressure...
December 5, 2016: International Forum of Allergy & Rhinology
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