1,388 results match your criteria Pituitary Apoplexy


Pituitary apoplexy causing acute ischemic stroke: Which treatment should be given priority.

Surg Neurol Int 2020 16;11:113. Epub 2020 May 16.

Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, Cheonan, Chungcheongnam-do-Korea, South Korea.

Background: Pituitary apoplexy is syndrome of sudden onset of headache, visual loss, pituitary dysfunction, and altered consciousness. Pituitary apoplexy followed by acute cerebral ischemia is extremely rare. Here, we introduced the case of successful surgical resection of pituitary adenoma which induced acute cerebral ischemia. Read More

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http://dx.doi.org/10.25259/SNI_82_2020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7265385PMC

Optimizing pre-, intra-, and postoperative management of patients with sellar pathology undergoing transsphenoidal surgery.

Neurosurg Focus 2020 Jun;48(6):E2

1Pituitary/Neuroendocrine Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; and.

Objective: Perioperative management of patients with sellar lesions is complex, requiring input from a multidisciplinary team of specialists for ongoing management of both endocrinological and neurosurgical issues. Here, the authors reviewed the experience of a single multidisciplinary center over 10 years to identify key postoperative practices that ensure positive outcomes for patients with sellar lesions who undergo transsphenoidal surgery.

Methods: The authors performed a retrospective review of all transsphenoidal operations carried out by the senior author at a single center from April 2008 through November 2018. Read More

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http://dx.doi.org/10.3171/2020.3.FOCUS2043DOI Listing

A curious case of vanishing pituitary adenoma.

Radiol Case Rep 2020 Jul 19;15(7):1050-1053. Epub 2020 May 19.

Department of Radiodiagnosis, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India.

Pituitary macroadenoma is the most common suprasellar lesion in adults. If symptomatic, it is managed surgically via transsphenoidal resection. Patients commonly present with headache and visual disturbances. Read More

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http://dx.doi.org/10.1016/j.radcr.2020.04.021DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7240058PMC

Takotsubo cardiomyopathy and pituitary apoplexy: a case report.

BMC Cardiovasc Disord 2020 May 19;20(1):236. Epub 2020 May 19.

Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China.

Background: Takotsubo cardiomyopathy (TTC) has been widely recognized in recent decades and is triggered by either physical or psychological stressors.

Case Presentation: A 70-year-old woman presented to the Emergency Department due to confusion, hypotension, fever, chills, and cough. She had a one-year history of diabetes insipidus. Read More

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http://dx.doi.org/10.1186/s12872-020-01521-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7236106PMC

55-year-old Woman with Headache, Vomiting, and Visual Disturbance.

Clin Pract Cases Emerg Med 2020 May 17;4(2):116-120. Epub 2020 Apr 17.

Rutgers New Jersey Medical School, Department of Emergency Medicine, Newark, New Jersey.

Case Presentation: A 55-year-old woman with a past medical history of hypertension, hyperlipidemia, and iron deficiency anemia presented to the emergency department with three days of headache, nausea, vomiting, and visual changes. Her vital signs were within normal limits. She was noted to have a left cranial nerve six palsy on exam. Read More

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http://dx.doi.org/10.5811/cpcem.2019.12.45546DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7219986PMC

Predicting prolonged length of stay after endoscopic transsphenoidal surgery for pituitary adenoma.

Int Forum Allergy Rhinol 2020 Jun 3;10(6):785-790. Epub 2020 May 3.

Department of Otolaryngology-Head & Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, PA.

Background: Endoscopic transsphenoidal surgery (ETS) for the resection of pituitary adenoma has become more common throughout the past decade. Although most patients have a short postoperative hospitalization, others require a more prolonged stay. We aimed to identify predictors for prolonged hospitalization in the setting of ETS for pituitary adenomas. Read More

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http://dx.doi.org/10.1002/alr.22540DOI Listing
June 2020
2.371 Impact Factor

Pericardial Effusion as an Initial Presentation of Panhypopituitarism.

Eur J Case Rep Intern Med 2020 24;7(4):001478. Epub 2020 Feb 24.

Department of Internal Medicine, Hospital Garcia de Orta, Almada, Portugal.

Pericardial effusion has a broad spectrum of clinical presentation, ranging from an incidental finding on imaging to a potentially fatal emergency such as pericardial tamponade, the most severe presentation. The authors present a case of a middle-aged male hospitalized due to shortness of breath. Initial work-up was positive for massive pericardial effusion with haemodynamic compromise. Read More

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http://dx.doi.org/10.12890/2020_001478DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7162561PMC
February 2020

Pituitary apoplexy secondary to pituitary macroadenoma, a diagnostic challenge

Rev Med Inst Mex Seguro Soc 2019 07 1;57(4):259-263. Epub 2019 Jul 1.

Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Departamento de Infectología, Servicio de Microbiología Clínica. Ciudad de México, México

Background: Pituitary apoplexy is a clinical syndrome reflecting a rapid expansion of sellar content, typically secondary to a stroke in a previous pituitary adenoma. This pathology is a rare complication, and, therefore, underdiagnosed. The consequences of a delay in the diagnosis are translated into serious functional and even deadly complications for the patient. Read More

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Rathke Cleft Cysts with Apoplexy-Like Symptoms: Clinicoradiologic Comparisons with Pituitary Adenomas with Apoplexy.

World Neurosurg 2020 Mar 23. Epub 2020 Mar 23.

Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Guro, Seoul, South Korea.

Background: Rathke cleft cyst (RCC) can cause acute symptoms mimicking pituitary adenoma (PA) apoplexy. We evaluated the clinicoradiologic features for distinguishing RCC from PA apoplexy.

Methods: We retrospectively evaluated 22 patients with RCC and 24 patients with PA with apoplexy-like symptoms who underwent surgery via a transsphenoidal approach between November 1999 and December 2016. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.03.086DOI Listing

Corticotroph adenoma and pituitary fungal infection: a rare association.

Endocrinol Diabetes Metab Case Rep 2020 Mar 25;2020. Epub 2020 Mar 25.

Endocrinology, Diabetes and Metabolism Department, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal.

Summary: Pituitary infections, particularly with fungus, are rare disorders that usually occur in immunocompromised patients. Cushing's syndrome predisposes patients to infectious diseases due to their immunosuppression status. We report the case of a 55-year-old woman, working as a poultry farmer, who developed intense headache, palpebral ptosis, anisocoria, prostration and psychomotor agitation 9 months after initial diabetes mellitus diagnosis. Read More

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http://dx.doi.org/10.1530/EDM-20-0010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7159253PMC

Impact of Medicaid insurance on outcomes following endoscopic transsphenoidal pituitary surgery.

J Neurosurg 2020 Mar 20:1-6. Epub 2020 Mar 20.

Departments of2Neurosurgery.

Objective: Despite the rise of studies in the neurosurgical literature suggesting that patients with Medicaid insurance have inferior outcomes, there remains a paucity of data on the impact of insurance on outcomes after endonasal endoscopic transsphenoidal surgery (EETS). Given the increasing importance of complications in quality-based healthcare metrics, the objective of this study was to assess whether Medicaid insurance type influences outcomes in EETS for pituitary adenoma.

Methods: The authors analyzed a prospectively acquired database of EETS for pituitary adenoma from 2005 to 2018 at NewYork-Presbyterian Hospital, Weill Cornell Medicine. Read More

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http://dx.doi.org/10.3171/2020.1.JNS192707DOI Listing

Clinicopathological analysis of 250 cases of pituitary adenoma under the new WHO classification.

Oncol Lett 2020 Mar 8;19(3):1890-1898. Epub 2020 Jan 8.

Department of Neurosurgery, Tianjin Huanhu Hospital, Tianjin 300000, P.R. China.

Pituitary adenomas (PAs) are a common subtype of intracranial tumors. The aim of the present study was to analyse the clinical and pathological features of different types of pituitary adenomas (PAs) according to the 2017 World Health Organisation Endocrine Organ Tumor Classification guidelines. The clinical data of 250 patients with PAs were collected and analysed. Read More

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http://dx.doi.org/10.3892/ol.2020.11263DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7039149PMC

Initial Gamma Knife radiosurgery for nonfunctioning pituitary adenomas: results from a 26-year experience.

Endocrine 2020 May 11;68(2):399-410. Epub 2020 Mar 11.

Department of Radiotherapy, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510260, Guangdong, China.

Objective: The aim of this study was to evaluate the long-term outcomes of initial Gamma Knife radiosurgery (GKRS) for patients with nonfunctioning pituitary adenomas (NFPAs).

Design And Methods: This was a single-center retrospective study. Eighty-one patients with NFPAs undergoing initial GKRS were enrolled. Read More

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http://dx.doi.org/10.1007/s12020-020-02260-1DOI Listing

Pituitary Apoplexy Accompanying Temporal Lobe Seizure as a Complication.

World Neurosurg 2020 Mar 5;138:153-157. Epub 2020 Mar 5.

Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan. Electronic address:

Background: Pituitary apoplexy is an acute clinical syndrome caused by infarction and/or hemorrhage of pituitary adenoma, which typically presents with severe headache, visual deterioration, and endocrine abnormalities. However, temporal lobe seizure (and temporal lobe epilepsy) has not been viewed as a symptom of pituitary apoplexy in the literature.

Case Description: To elucidate further such a rare complication of temporal lobe seizure, we describe here the rare clinical manifestations of a 55-year-old previously healthy man with pituitary apoplexy harboring headache, combined palsies involving cranial nerves III to VI, endocrinologic disturbances, and temporal lobe seizure. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.02.148DOI Listing

Letter to the Editor Regarding "Pituitary Apoplexy: Large Surgical Series with Grading System".

World Neurosurg 2020 03;135:405

Department of Neurological Surgery, University of Utah School of Medicine, Salt Lake City, Utah, USA.

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http://dx.doi.org/10.1016/j.wneu.2019.11.174DOI Listing

Comparative preoperative characteristics and postoperative outcomes at a private versus a safety-net hospital following endoscopic endonasal transsphenoidal resection of pituitary adenomas.

J Neurosurg 2020 Feb 28:1-8. Epub 2020 Feb 28.

1Department of Neurosurgery.

Objective: Sociodemographic disparities in health outcomes are well documented, but the effects of such disparities on preoperative presentation of pituitary adenomas (PA) and surgical outcomes following resection are not completely understood. In this study the authors sought to compare the preoperative clinical characteristics and postoperative outcomes in patients undergoing PA resection at a private hospital (PH) versus a safety-net hospital (SNH).

Methods: The authors conducted a retrospective review over a 36-month period of patients with PAs who underwent endoscopic endonasal transsphenoidal surgery performed by the same attending neurosurgeon at either a PH or an SNH at a single academic medical institution. Read More

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http://dx.doi.org/10.3171/2019.12.JNS192506DOI Listing
February 2020

Secondary Pituitary Abscess Inside Adenoma: A Case Report and Review of Literature.

World Neurosurg 2020 May 17;137:281-285. Epub 2020 Feb 17.

Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China. Electronic address:

Background: Pituitary abscesses within pre-existing pituitary conditions, such as craniopharyngioma, pituitary adenoma, or Rathke cleft cyst, are quite rare. A case of pituitary abscess secondary to adenoma is presented, and the literature is reviewed.

Case Description: An 11-year-old boy presented with a 3-day history of sudden-onset headache and visual loss. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.02.057DOI Listing

In Reply to the Letter to the Editor Regarding "Visual and Endocrine Recovery Following Conservative and Surgical Treatment of Pituitary Apoplexy: A Meta-Analysis".

World Neurosurg 2020 02;134:672-673

Department of Neurological Surgery, University of California, Irvine, California, USA. Electronic address:

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http://dx.doi.org/10.1016/j.wneu.2019.11.095DOI Listing
February 2020

Letter to the Editor Regarding "Visual and Endocrine Recovery Following Conservative and Surgical Treatment of Pituitary Apoplexy: A Meta-Analysis".

World Neurosurg 2020 02;134:671

Department of Neurosurgery, Clinical Medical College of Yangzhou University, Yangzhou, China. Electronic address:

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http://dx.doi.org/10.1016/j.wneu.2019.10.167DOI Listing
February 2020

Pituitary Apoplexy Case Series: Outcomes After Endoscopic Endonasal Transsphenoidal Surgery at a Single Tertiary Center.

World Neurosurg 2020 May 4;137:e366-e372. Epub 2020 Feb 4.

Department of Neurological Surgery, Keck School of Medicine of University of Southern California, Los Angeles, California, USA; USC Pituitary Center, Keck School of Medicine of University of Southern California, Los Angeles, California, USA. Electronic address:

Background: The management of pituitary apoplexy, caused by acute hemorrhage and/or infarction of a pituitary adenoma, is debated.

Objective: To analyze clinical characteristics of patients undergoing endoscopic endonasal approaches (EEAs) for pituitary apoplexy.

Methods: A retrospective review of patients at our institution from 2012 to 2018 undergoing EEA for pituitary apoplexy diagnosed clinically and with imaging/pathologic findings. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.01.204DOI Listing

CENTRAL HYPOTHYROIDISM IN SEVERE SEPSIS.

Acta Endocrinol (Buchar) 2019 Jul-Sep;15(3):372-377

"Prof. Dr. Matei Bals" National Institute of Infectious Diseases, Bucharest, Romania.

Objective: A partial or complete deficiency of hormone secretion by pituitary gland (hypopituitarism) is commonly seen after a pituitary apoplexy caused by an infarction of a pituitary adenoma or pituitary hyperplasia (as in Sheehan's syndrome). Hypopituitarism may also follow surgery, when hypovolemia, anticoagulation, fat/air/bone marrow microemboli can provoke a pituitary infarction/hemorrhage. Other causes of abrupt hypophyseal hypoperfusion, as hypovolemia during a septic shock, could also contribute. Read More

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http://dx.doi.org/10.4183/aeb.2019.372DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6992395PMC
February 2020

Concurrent pituitary apoplexy and posterior reversible encephalopathy syndrome in a patient with end-stage renal disease on hemodialysis: A case report.

Medicine (Baltimore) 2020 Jan;99(5):e18987

Department of Internal Medicine, HANSUNG Union Internal Medicine Clinic and Dialysis Center, Daegu, Republic of Korea.

Rationale: Pituitary apoplexy (PA) and posterior reversible encephalopathy syndrome (PRES) are rare neurologic diseases that show acute neuro-ophthalmologic symptoms such as headache, decreased visual acuity, and altered consciousness. These diseases are rarely found in patients with end-stage renal disease (ESRD) on hemodialysis, and simultaneous occurrence of these 2 diseases has not been reported.

Patient Concerns: The patient was a 75-year-old man with a history of hypertension, diabetes mellitus, and non-functioning pituitary macroadenoma. Read More

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http://dx.doi.org/10.1097/MD.0000000000018987DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7004754PMC
January 2020

Significant Benefits of AIP Testing and Clinical Screening in Familial Isolated and Young-onset Pituitary Tumors.

J Clin Endocrinol Metab 2020 Jun;105(6)

Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.

Context: Germline mutations in the aryl hydrocarbon receptor-interacting protein (AIP) gene are responsible for a subset of familial isolated pituitary adenoma (FIPA) cases and sporadic pituitary neuroendocrine tumors (PitNETs).

Objective: To compare prospectively diagnosed AIP mutation-positive (AIPmut) PitNET patients with clinically presenting patients and to compare the clinical characteristics of AIPmut and AIPneg PitNET patients.

Design: 12-year prospective, observational study. Read More

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http://dx.doi.org/10.1210/clinem/dgaa040DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7137887PMC

Comparison of intraoperative cortisol levels after preoperative hydrocortisone administration versus placebo in patients without adrenal insufficiency undergoing endoscopic transsphenoidal removal of nonfunctioning pituitary adenomas: a double-blind randomized trial.

J Neurosurg 2020 Jan 24:1-9. Epub 2020 Jan 24.

Departments of1Anesthesiology and Pain Medicine.

Objective: In this double-blind randomized trial, the necessity of preoperative steroid administration in patients without adrenal insufficiency (AI) undergoing endoscopic transsphenoidal surgery (ETSS) for pituitary adenoma was evaluated.

Methods: Forty patients with and without AI, defined as a peak cortisol level > 18 µg/dl on the insulin tolerance test or rapid adrenocorticotropic hormone (ACTH) test, undergoing ETSS for nonfunctioning pituitary adenomas were randomly allocated to treatment with either 100 mg of preoperative hydrocortisone (group HC, n = 20) or normal saline (group C, n = 20). The patients with pituitary apoplexy, the use of a drug within the last 3 months that could affect the hypothalamic-pituitary-adrenal axis, or a previous history of brain or adrenal surgery were excluded. Read More

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http://dx.doi.org/10.3171/2019.11.JNS192381DOI Listing
January 2020
3.737 Impact Factor

Pituitary apoplexy mimicking meningoencephalitis: case report and scoping study.

Hosp Pract (1995) 2020 Feb 6;48(1):29-34. Epub 2020 Feb 6.

Departments of Neurology, Lehigh Valley Health Network, Allentown, Pennsylvania.

: Pituitary apoplexy (PA) is a rare but potentially life-threatening condition that may require urgent surgical intervention.: We report a case of a patient who was initially diagnosed with meningoencephalitis (ME) based on clinical presentation and cerebrospinal fluid (CSF) analysis, but was eventually diagnosed with PA. We present a summary of other cases reported in the literature of PA mimicking ME and analyze their clinical features and CSF findings. Read More

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http://dx.doi.org/10.1080/21548331.2020.1717801DOI Listing
February 2020

Evolution of macroprolactinomas during pregnancy: A cohort study of 85 pregnancies.

Clin Endocrinol (Oxf) 2020 May 4;92(5):421-427. Epub 2020 Feb 4.

Service d'Endocrinologie - Diabète - Nutrition, Centre Hospitalier Universitaire de Reims, Reims, France.

Objective: Pregnancy in patients with macroprolactinomas has been associated with a higher risk of pituitary tumour growth. However, the incidence and risk factors remain unclear. We aimed to evaluate the evolution of macroprolactinomas during pregnancy and to identify potential risk factors. Read More

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http://dx.doi.org/10.1111/cen.14162DOI Listing

[Case report: transient ischemic stroke caused by internal carotid artery occlusion due to compression by pituitary apoplexy and hemodynamic mechanism].

Rinsho Shinkeigaku 2020 Feb 19;60(2):146-151. Epub 2020 Jan 19.

Division of Cerebrovascular Medicine and Neurology, National Hospitalization Organization, Kyushu Medical Center.

An 87-year-old blind man was admitted due to repeatedly disturbed consciousness and fever. Brain CT showed a pituitary tumor with a hematoma and an occlusive lesion of the right internal carotid artery. He experienced consciousness disturbance and left limb weakness with hypotension for a few minutes on the day of admission. Read More

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http://dx.doi.org/10.5692/clinicalneurol.cn-001372DOI Listing
February 2020

Pituitary tumors: epidemiology and clinical presentation spectrum.

Hormones (Athens) 2020 Jun 14;19(2):145-155. Epub 2020 Jan 14.

Neuroendocrinology Unit, Endocrinology Department, Ramón y Cajal University Hospital, Madrid, Spain.

Pituitary tumors (PTs) are a heterogeneous group of lesions of the central nervous system that are usually benign. Most of them occur sporadically, but 5% can do so within family syndromes, usually at a young age. There are differences by sex, age, race, and genetic factors in the prevalence of different tumor cell types and clinical presentation. Read More

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http://dx.doi.org/10.1007/s42000-019-00168-8DOI Listing

Evaluation of prognostic utility of Ki-67, P53, and O-6-methylguanine-DNA methyltransferase expression in pituitary tumors.

J Lab Physicians 2019 Oct-Dec;11(4):323-329

Department of Endocrinology, IPGME and R, Kolkata, West Bengal, India.

Background Or Context: Pituitary adenoma (PA) is the most common pathology of the pituitary gland. Pituitary tumors were historically considered benign, however, from recent advances in pathological and molecular analyses, numerous prognostic markers have been identified, allowing a better characterization of tumor behavior and prediction of response to treatment and recurrences.

Aims And Objectives: Evaluation of the epidemiological occurrence of pituitary tumors in our center and prediction of the benign, aggressive, or malignant nature of the tumor with the help of immunohistochemical markers (IHC) Ki-67, P53, and O-6-methylguanine-DNA methyltransferase (MGMT) along with radiology. Read More

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http://dx.doi.org/10.4103/JLP.JLP_76_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6943861PMC
January 2020

Anesthetic management of a patient with Sheehan's syndrome and twin pregnancy while undergoing a cesarean section.

Authors:
G Arora N Sahni

J Postgrad Med 2020 Jan-Mar;66(1):51-53

Department of Anesthesia and Intensive Care, PGIMER, Chandigarh, India.

Sheehan's syndrome (SS) is caused by infarction of the pituitary gland usually precipitated by hypotension due to massive uterine hemorrhage during the peripartum period. Once SS develops, it becomes a major comorbidity for the young females and predisposes them to further medical, obstetric, and anesthetic complications. Herein, we report the perioperative anesthetic management of a 28-year-old female, already diagnosed with SS precipitated by urosepsis and septicemic shock in a previous pregnancy, now presenting with twin pregnancy for elective cesarean section. Read More

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http://dx.doi.org/10.4103/jpgm.JPGM_473_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6970334PMC
January 2020

Cut-off values for sufficient cortisol response to low dose Short Synacthen Test after surgery for non-functioning pituitary adenoma.

Acta Neurochir (Wien) 2020 Apr 6;162(4):845-852. Epub 2020 Jan 6.

Section of Specialized Endocrinology, Rikshospitalet, Oslo University Hospital, Oslo, Norway.

Objective: The aim was to study the prevalence of secondary adrenal insufficiency before and after surgery for non-functioning pituitary adenomas, as well as determine risk factors for developing secondary adrenal insufficiency. A secondary aim was to determine adequate p-cortisol response to a 1-μg Short Synacthen Test after surgery.

Design: Longitudinal cohort study. Read More

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http://dx.doi.org/10.1007/s00701-019-04068-zDOI Listing

Pituitary Apoplexy Following Systemic Anticoagulation.

Eur J Case Rep Intern Med 2019 1;6(12):001254. Epub 2019 Nov 1.

Internal Medicine Department IV, Hospital São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal.

Pituitary apoplexy is a rare medico-surgical emergency that stems from an acute expansion of a pituitary adenoma from infarction or haemorrhage and where the treatment strategy is still controversial. Clinical presentation is highly variable and a high index of suspicion is needed to make the diagnosis. Furthermore, in less than half of cases, a precipitating event is identified. Read More

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http://dx.doi.org/10.12890/2019_001254DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6936922PMC
November 2019

Pituitary Apoplexy May Be Mistaken for Temporal Arteritis.

Eur J Case Rep Intern Med 2019 16;6(11):001261. Epub 2019 Oct 16.

Hospital Professor Doutor Fernando Fonseca, Serviço de Medicina II, Amadora, Portugal.

Pituitary apoplexy is a rare endocrine emergency, characterized by a sudden increase in pituitary gland volume secondary to acute ischaemic infarction or haemorrhage of the pituitary gland, usually in the presence of a pituitary adenoma. We present the case of a 79-year-old man admitted for new-onset, bi-temporal and severe headache, associated with photophobia and vomiting, whose additional study revealed pituitary apoplexy. This case highlights the need for high clinical suspicion of this rare entity in order to reduce the associated mortality. Read More

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http://dx.doi.org/10.12890/2019_001261DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6886638PMC
October 2019

Clinical investigation of pituitary incidentalomas: A two-center study.

Intractable Rare Dis Res 2019 Nov;8(4):239-244

Department of Endocrinology and Diabetes Mellitus, Fukuoka University Chikushi Hospital, Chikusino, Fukuoka, Japan.

Recent advances in imaging technology resulted in an increase in pituitary incidentalomas (PIs) detection. PIs were reported to be present in 1.6% persons with magnetic resonance imaging of the brain. Read More

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http://dx.doi.org/10.5582/irdr.2019.01083DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6929595PMC
November 2019

Pituitary adenoma and apoplexy during GnRH agonist treatment for IVF - case report.

Gynecol Endocrinol 2019 Dec 23:1-3. Epub 2019 Dec 23.

Centre of Gynecology, Endocrinology and Reproductive Medicine, ARTEMIDA, Olsztyn, Poland.

fertilization is commonly used for treating infertility. One stage of this process is controlled hyperstimulation of the ovaries, achieved by administering gonadotropins. There are several stimulation protocols utilized that increase the number of ovarian follicles during IVF. Read More

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http://dx.doi.org/10.1080/09513590.2019.1706086DOI Listing
December 2019

Imaging findings in hypophysitis: a review.

Radiol Med 2020 Mar 20;125(3):319-328. Epub 2019 Dec 20.

Department of Neurological and Sensorineural Sciences, Azienda ospedaliero-universitaria Senese, Policlinico "Santa Maria alle Scotte", Siena, Italy.

Hypophysitis (HP) is a rare acute or chronic inflammatory condition of the pituitary gland. The greatest challenge in the management of HP is establishing a diagnosis through clinical criteria and non-invasive methods and predicting the patients' clinical outcome. The aim of this review is to describe the neuroradiological findings of this rare disease, providing some information regarding the possible differential diagnosis in order to avoid unnecessary surgery. Read More

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http://dx.doi.org/10.1007/s11547-019-01120-xDOI Listing

A Case Report from the Ancient Past.

Authors:
William H Adams

Am J Case Rep 2019 Dec 20;20:1907-1914. Epub 2019 Dec 20.

Retired, Hobart, NY, USA.

BACKGROUND Standard translations of Hippocratic works are sometimes misleading because the translators knew less about their subject than did the ancient authors. CASE REPORT A new translation and explication of a chapter from a Hippocratic work of the fifth century before the Common Era (BCE), Diseases II, describes patients with pituitary apoplexy and subsequent myxedema, the 2 events separated by as much as 14 years. CONCLUSIONS The association of myxedema with an intracranial event that occurred years earlier predates by 2400 years the causal association of a pituitary adenoma with hormonal deficiency. Read More

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http://dx.doi.org/10.12659/AJCR.919830DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6938251PMC
December 2019

Management of Hypopituitarism.

J Clin Med 2019 Dec 5;8(12). Epub 2019 Dec 5.

Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, University of Oxford, OX3 7LE, Oxford, UK.

Hypopituitarism includes all clinical conditions that result in partial or complete failure of the anterior and posterior lobe of the pituitary gland's ability to secrete hormones. The aim of management is usually to replace the target-hormone of hypothalamo-pituitary-endocrine gland axis with the exceptions of secondary hypogonadism when fertility is required, and growth hormone deficiency (GHD), and to safely minimise both symptoms and clinical signs. Adrenocorticotropic hormone deficiency replacement is best performed with the immediate-release oral glucocorticoid hydrocortisone (HC) in 2-3 divided doses. Read More

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http://dx.doi.org/10.3390/jcm8122153DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6947162PMC
December 2019

Osmotic Demyelination Syndrome Triggered by Pituitary Apoplexy.

Intern Med 2020 Mar 22;59(6):869-870. Epub 2019 Nov 22.

Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan.

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http://dx.doi.org/10.2169/internalmedicine.3678-19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7118385PMC

Pituitary apoplexy.

Neurol Neurochir Pol 2019 20;53(6):413-420. Epub 2019 Nov 20.

Department of Neurology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland.

Pituitary apoplexy (PA) is a clinical syndrome caused by acute haemorrhage and/or infarction of the pituitary gland, generally within a frequently undiagnosed pituitary adenoma. The sudden increase in pituitary gland volume is responsible for typical symptoms: severe headache, nausea, vomiting, visual impairment, cranial nerve palsies, deteriorating level of consciousness, and hypopituitarism. Radiological evidence, especially magnetic resonance imaging (MRI) which is the most sensitive diagnostic modality, establishes the diagnosis. Read More

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http://dx.doi.org/10.5603/PJNNS.a2019.0054DOI Listing
January 2020

Imaging of Altered Mental Status.

Authors:
Alina Uzelac

Radiol Clin North Am 2020 Jan 18;58(1):187-197. Epub 2019 Oct 18.

Neuroradiology, Department of Radiology, Zuckerberg San Francisco General Hospital, University of California, 1001 Potrero Avenue, Room 1X56, San Francisco, CA 94110, USA. Electronic address:

Neuroimaging is an invaluable diagnostic tool for sorting through the vast array of etiologies that underlie altered mental status (AMS). Head computed tomography (CT) without contrast is the primary modality for evaluation of AMS and should be complemented by MR imaging in cases of negative CT but high clinical concern. Studies to maximize brain imaging efficiency and improve the yield of positive scans through the utilization of clinical and laboratory pre-scan diagnostics are ongoing. Read More

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http://dx.doi.org/10.1016/j.rcl.2019.08.002DOI Listing
January 2020

A rare case of retroclival epidural hematoma: case report and review of the literature.

Acta Neurol Belg 2019 Nov 12. Epub 2019 Nov 12.

Department of Neurosurgery, Humanitas University, Rozzano, Italy.

Retroclival epidural hematomas (REDHs) are rare and almost exclusively found in the pediatric age group. Frequently, the etiology is related to accidental trauma, though other mechanisms have been observed, including coagulopathy, non-accidental trauma, and pituitary apoplexy. A 76-year-old man was admitted to our emergency department after a loss of consciousness. Read More

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http://dx.doi.org/10.1007/s13760-019-01238-9DOI Listing
November 2019

Heparin-Induced Pituitary Apoplexy Presenting as Isolated Unilateral Oculomotor Nerve Palsy: A Case Report and Literature Review.

Case Rep Endocrinol 2019 9;2019:5043925. Epub 2019 Oct 9.

Department of Neurosurgery and the Pituitary and Neuroendocrine Center, University of Michigan, Ann Arbor, MI, USA.

Introduction: Pituitary apoplexy (PA) is a rare and potentially life-threatening clinical syndrome resulting from pituitary gland hemorrhage and/or infarction. Anticoagulation is a risk factor for triggering PA. Isolated oculomotor nerve palsy is an atypical presentation of PA. Read More

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http://dx.doi.org/10.1155/2019/5043925DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6803741PMC
October 2019
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Gonadotrophin-releasing hormone agonist-induced pituitary adenoma apoplexy and casual finding of a parathyroid carcinoma: A case report and review of literature.

World J Clin Cases 2019 Oct;7(20):3259-3265

Department of Endocrinology, Complejo Hospitalario Universitario A Coruña, A Coruña 15006, Spain.

Background: Pituitary apoplexy represents one of the most serious, life threatening endocrine emergencies that requires immediate management. Gonadotropin-releasing hormone agonist (GnRHa) can induce pituitary apoplexy in those patients who have insidious pituitary adenoma coincidentally.

Case Summary: A 46-year-old woman, with a history of hypertension and menorrhagia was transferred to our hospital from a secondary care hospital after complaints of headache and vomiting, with loss of consciousness 5 min after an injection of GnRHa. Read More

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http://dx.doi.org/10.12998/wjcc.v7.i20.3259DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6819301PMC
October 2019
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Rathke's Cleft Cyst Apoplexy in Two Teenage Sisters.

Pediatr Neurosurg 2019 21;54(6):428-435. Epub 2019 Oct 21.

Department of Neurosurgery, Medical University of South Carolina (MUSC), Charleston, South Carolina, USA,

Rathke's cleft cysts (RCC) are sellar-suprasellar cysts that are usually discovered incidentally given their indolent clinical course. When symptoms do arise, the most common clinical presentation is headache, visual field deficits due to visual pathway compression, diplopia due to cavernous sinus compression, chemical meningitis due to spillage of the cyst contents, endocrine dysfunction, and very rarely apoplexy. We present 2 cases of RCC in sisters who developed a sudden onset of symptoms in a manner similar to pituitary apoplexy. Read More

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http://dx.doi.org/10.1159/000503112DOI Listing

Extraordinary case presentations in pediatric pituitary adenoma: report of 6 cases.

J Neurosurg Pediatr 2019 Oct 11:1-8. Epub 2019 Oct 11.

Pediatric pituitary adenomas (PPAs) are rare neoplasms with a propensity for unusual presentations and an aggressive clinical course. Here, the authors describe 6 highly atypical PPAs to highlight this tendency and discuss unexpected management challenges.A 14-year-old girl presented with acute hemiparesis and aphasia. Read More

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http://dx.doi.org/10.3171/2019.7.PEDS1950DOI Listing
October 2019
2 Reads

Acute Headache in the Emergency Setting.

Radiographics 2019 Oct;39(6):1739-1759

From the Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, 1653 W Congress Pkwy, Chicago, IL 60612.

Acute headache is a common symptom and is reported by approximately 2%-4% of patients who present to the emergency department. Many abnormalities manifest with headache as the first symptom, and it is crucial to obtain a patient's complete clinical history for correct diagnosis. Headache onset, duration, and severity; risk factors such as hypertension, immunosuppression, or malignancy; and the presence of focal neurologic deficits or systemic symptoms may aid the radiologist in deciding whether imaging is appropriate and which modality to choose. Read More

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http://dx.doi.org/10.1148/rg.2019190017DOI Listing
October 2019
1 Read
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Atypical teratoid/rhabdoid tumor presenting with subarachnoid and intraventricular hemorrhage.

Surg Neurol Int 2019 5;10:139. Epub 2019 Jul 5.

Department of Neurosurgery, University of Texas Health San Antonio, San Antonio, Texas, United States.

Background: Sellar masses comprise 14-18% of all intracranial tumors. Pituitary adenomas account for 85% of these lesions, while 15% of sellar masses stem from other etiologies. Intratumoral hemorrhage (apoplexy), while not exceptionally common, can be discovered at presentation. Read More

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http://dx.doi.org/10.25259/SNI-59-2019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6744721PMC
July 2019
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Hemorrhagic Presentation of Rathke Cleft Cysts: A Surgical Case Series.

Oper Neurosurg (Hagerstown) 2020 May;18(5):470-479

Department of Neurological Surgery, University of Southern California Keck School of Medicine, Los Angeles, California.

Background: Rathke cleft cysts (RCCs) are benign sellar and suprasellar lesions commonly presenting as asymptomatic incidental findings. Rarely, RCCs hemorrhage and mimic pituitary apoplexy on presentation.

Objective: To review a series of hemorrhagic RCCs for physicians encountering this rare presentation. Read More

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http://dx.doi.org/10.1093/ons/opz239DOI Listing
May 2020
3 Reads