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https://www.readbyqxmd.com/read/29107171/progression-from-isolated-growth-hormone-deficiency-to-combined-pituitary-hormone-deficiency
#1
REVIEW
Manuela Cerbone, Mehul T Dattani
Growth hormone deficiency (GHD) can present at any time of life from the neonatal period to adulthood, as a result of congenital or acquired insults. It can present as an isolated problem (IGHD) or in combination with other pituitary hormone deficiencies (CPHD). Pituitary deficits can evolve at any time from GHD diagnosis. The number, severity and timing of occurrence of additional endocrinopathies are highly variable. The risk of progression from IGHD to CPHD in children varies depending on the etiology (idiopathic vs organic)...
October 19, 2017: Growth Hormone & IGF Research
https://www.readbyqxmd.com/read/29027644/treatment-of-empty-sella-associated-with-visual-impairment-a-systematic-review-of-chiasmapexy-techniques
#2
REVIEW
Lina Raffaella Barzaghi, Carmine Antonio Donofrio, Pietro Panni, Marco Losa, Pietro Mortini
PURPOSE: Chiasmapexy is a poorly described surgical procedure adopted to correct the downward displacement of suprasellar visual system (SVS) into an empty sella (ES) causing visual worsening. The aim of our study is to define the indications for extradural and intradural chiasmapexy. METHODS: A systematic literature review has been performed on MEDLINE database (US National Library of Medicine), including only articles that depicted cases of surgically treated patients affected by ES and progressive delayed visual worsening...
October 13, 2017: Pituitary
https://www.readbyqxmd.com/read/28983769/temporal-lobe-epilepsy-due-to-meningoencephaloceles-into-the-greater-sphenoid-wing-a-consequence-of-idiopathic-intracranial-hypertension
#3
H Urbach, G Jamneala, I Mader, K Egger, S Yang, D Altenmüller
PURPOSE: Antero-inferior temporal lobe meningoencephaloceles are a rare, but increasingly recognized cause of drug-resistant temporal lobe epilepsy (TLE). In order to evaluate whether these lesions are related to idiopathic intracranial hypertension (IIH), we analyzed clinical and MRI findings of a cohort of patients undergoing presurgical work-up. METHODS: Seizure onset in the anterior temporal lobe was proven by EEG electrodes in 22 patients, and in 21 patients, anterior temporal lobectomy (mostly with sparing of the hippocampus) was performed...
October 5, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28954263/beneficial-effects-of-high-doses-of-cabergoline-in-the-treatment-of-giant-prolactinoma-resistant-to-dopamine-agonists-a-case-report-with-a-21-year-follow-up
#4
Lucas Faria de Castro, Maria de Fátima Magalhães Gonzaga, Luciana Ansaneli Naves, José Luiz Mendonça, Benicio Oton de Lima, Luiz Augusto Casulari
INTRODUCTION: Prolactinomas are pituitary tumors with a very low prevalence in childhood and adolescence compared to adulthood. This condition is preferentially treated with dopamine agonists. Resistance to these drugs is rare. CASE REPORT: We describe the case of a boy diagnosed with macroadenoma at the age of 9 and followed up for 21 years. He did not fully respond to treatment with dopamine agonists. His initial prolactin level was 2,400 ng/mL (in males, normal values are <16...
September 26, 2017: Hormone Research in Pædiatrics
https://www.readbyqxmd.com/read/28937488/the-significance-of-arachnoid-granulation-in-patients-with-idiopathic-intracranial-hypertension
#5
Gaurav Vishwasrao Watane, Bhumi Patel, Derek Brown, M Reza Taheri
PURPOSE: The aim of this article was to study the significance of arachnoid granulations (AGs) in patients with idiopathic intracranial hypertension (IIH). METHODS: In an institutional review board-approved retrospective chart review study, 79 patients with clinical diagnosis of idiopathic increased intracranial pressure were compared with 63 patients with a diagnosis of multiple sclerosis. Inclusion criteria also included available magnetic resonance imaging (MRI) of the brain, older than 18 years, and female sex...
September 20, 2017: Journal of Computer Assisted Tomography
https://www.readbyqxmd.com/read/28875121/spontaneous-cerebrospinal-fluid-rhinorrhea-association-with-body-weight-and-imaging-data
#6
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-2-cases-of-visual-impairment-caused-by-empty-sella-syndrome
#7
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 cleft cyst...
November 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28780516/diagnosis-of-endocrine-disease-primary-empty-sella-a-comprehensive-review
#8
REVIEW
S Chiloiro, A Giampietro, A Bianchi, T Tartaglione, A Capobianco, C Anile, L De Marinis
Primary empty sella (PES) is characterized by the herniation of the subarachnoid space within the sella, which is often associated with variable degrees of flattening of the pituitary gland in patients without previous pituitary pathologies. PES pathogenetic mechanisms are not well known but seem to be 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 a 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, which delineates from the so called PES syndrome...
December 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
#9
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
#10
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
#11
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
#12
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
#13
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...
August 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28469923/macroprolactinoma-appearing-after-resolution-of-hydrocephalus
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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