Injury to Cranial Nerves and Optic Chiasm

1974 ◽  
pp. 162-166
Author(s):  
W. Bryan Jennett
Keyword(s):  
Cranial Nerves ◽  
Optic Chiasm

Impact of Prolactin Hipersecrey on Glucid and Lipid Metabolisms

2019 ◽  
Vol 70 (5) ◽  
pp. 1603-1607
Author(s):  
Elena Ionescu ◽  
Bogdan Virgil Cotoi ◽  
Anca Ganescu
Keyword(s):  
Cranial Nerves ◽  
Pituitary Tumors ◽  
Optic Chiasm ◽  
Anterior Lobe ◽  
Visual Field Defects ◽  
Large Tumor ◽  
Metabolic Complications ◽  
Clinical Onset ◽  
Vision Defects ◽  
Upper Level

Pituitary is a common terrain for the appearance of tumoral changes, representing the origin of about 15% of all intracranial tumors [13]. These tumors are, for the most part, histologically benign, as they arise from hormone secreting cells in the anterior lobe. Therefore, the aim of the paper is to specify the clinical and paraclinical clinical onset characteristics, the evolutionary peculiarities, as well as the metabolic complications secondary to the prolactin hypersecretion. The effects of prolactin-secreting pituitary tumors may occur as a result of mass effects of tumors or even hyperprolactinaemia. Because microadenomas are intrathecal, visual defects may not occur, but headaches occur more often (50%) than normal (27%) [1, 6]. A large tumor that extends beyond the limbs of the turkey can cause headaches and vision defects. The classical presentation is bitemporal hemianopsia due to the compression of the optic chiasm from a tumor that extends to the upper level. If chiasma is prefixed or if the tumor extends posteriorly, compression of a single optical system results in visual field defects similar. The lateral extension in the cavernous sinus can lead to the illness of the oculomotor function involving the cranial nerves III, IV and VI and the branches V1 and V2 of the cranial nerve V, alone or in combinations.

scholarly journals Successful Pregnancies in an Acromegalic Woman After Non-Radical Pituitary Adenomectomy for Somatoprolactinoma

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A612-A612
Author(s):  
Anna Catarina Gatzk Arruda ◽  
Giovana Outuki ◽  
Marcos Antonio Dias ◽  
Alexandre Jose Faria Carrilho ◽  
Tania Longo Mazzuco
Keyword(s):  
Fertility Restoration ◽  
Cranial Nerves ◽  
Optic Chiasm ◽  
Screening Tests ◽  
Blood Levels ◽  
Primary Amenorrhea ◽  
Biochemical Control ◽  
Octreotide Lar ◽  
Post Surgery ◽  
Tumor Residue

Abstract Background: Pregnancy is unusual in patients with acromegaly due to somatotropinomas or somatoprolactinomas. Fertility is impaired because of hormonal hypersecretion, pituitary damage by tumor compression or both. Managing somatoprolactinomas and fertility issues are often challenging. Clinical Case: A 20-year woman with primary amenorrhea and headache was diagnosed with hypogonadotrophic hypogonadism secondary to hyperprolactinemia (2500 µg/L, n<23 µg/L). No other abnormalities were found on the pituitary function screening tests. MRI revealed an intra and suprasellar adenoma (2.5x1.8x1.8 cm) with optic chiasm compression. The onset of menses occurred after 11 months under dopaminergic treatment, and tumor size diminished (1.9x1.5x1.5 cm), bringing on optic chiasm decompression. She remained under dopamine agonist treatment for 6 years, when she realized extremities enlargement and height increase by 3 cm. Acromegaly was confirmed by blood levels of IGF-1 (3.37xULN), GH (8 µg/L, n<8 µg/L), and GH nadir (4.3 µg/L, n<1 µg/L) during OGTT. Then, octreotide LAR was added to cabergoline treatment while waiting for elective surgical treatment. She underwent to transsphenoidal endonasal neurosurgical microscopy approach guided by neuronavigation, with the removal of a large portion of tumor. However, it was not possible to extract the part of invasive adenoma close to right carotid artery due to the risk of vascular and intracavernous cranial nerves injury. Immunohistochemistry analysis of the adenoma was positive only for GH cells with low Ki67 index (<1%). Due to the poor biochemical control (unsuppressed post-OGTT GH, IGF-1 1.66xULN and PRL 301 µg/L) and the presence of a small stable tumor residue, treatment with cabergoline and somatostatin analogues was maintained (3-year octreotide LAR, transitioned to lanreotide in an attempt to achieve a better biochemical response). After 14 years of the initial diagnosis and 5 years post-surgery, the patient expressed the desire to get pregnant and all medications in use were suspended. In the following 3 years, she had two uneventful gestation without complications or worsen of acromegaly; she only breastfed for few months after her first pregnancy. The second one was a twin pregnancy. After one year, the MRI revealed no increase of tumor mass (1.0x0.3x1.0 cm), and PRL levels withing normal range, IGF-1 slightly elevated, but GH not suppressed by OGTT. Cabergoline was reintroduced and the biochemical control of acromegaly was achieved. Conclusion: We reported the very unusual spontaneous conception and normal course of pregnancies in a woman with acromegaly, who was submitted to successful transsphenoidal neurosurgical microscopy approach in which large part of the tumor was removed and the normal pituitary tissue was preserved, allowing fertility restoration.

Surgical Management of Cavernous Malformations Involving the Cranial Nerves

Neurosurgery ◽  
2003 ◽  
Vol 53 (2) ◽  
pp. 352-357 ◽  
Author(s):  
Vivek R. Deshmukh ◽  
Felipe C. Albuquerque ◽  
Joseph M. Zabramski ◽  
Robert F. Spetzler
Keyword(s):  
Cranial Nerves ◽  
Surgical Techniques ◽  
Optic Chiasm ◽  
Symptom Improvement ◽  
Subtotal Resection ◽  
Cavernous Malformations ◽  
Male Patients ◽  
Acute Hearing Loss ◽  
Age Range ◽  
Specific Symptoms

Abstract OBJECTIVE To analyze the indications and techniques pertinent to the treatment of cranial nerve (CN) cavernous malformations (CMs). METHODS CN CMs are lesions isolated to the CNs. CMs affecting the optic nerve (CN II), oculomotor nerve (CN III), facial/vestibulocochlear complex (CN VII and CN VIII), and hypoglossal nerve (CN XII) have been described. The records for six patients were reviewed with respect to lesion location, symptoms, surgical approach, and therapeutic considerations. This is the largest series of CMs isolated to CNs reported to date. RESULTS Three female patients and three male patients (age range, 28–76 yr; mean age, 41 yr) presented with six CN lesions; four lesions involved the optic chiasm and two involved CN VII and CN VIII. The patients with chiasmatic lesions presented with acute visual deterioration. Both patients with CN VII/CN VIII lesions exhibited acute hearing loss. The level of deterioration suggested CM hemorrhage. Orbitozygomatic craniotomies were performed for chiasmatic lesions, and retrosigmoid craniotomies were performed for cerebellopontine angle lesions. All patients experienced symptom improvement after surgery. One chiasmatic lesion recurred after 2 years and required resection. CONCLUSION CN CMs present with site-specific symptoms and require complex surgical techniques for resection. These lesions are frequently symptomatic, because of the eloquence of the tissue of origin. Therefore, all CN CMs should be resected. Subtotal resection uniformly results in disease and symptom recurrence. CN CMs can be resected safely, with preservation of CN function.

Pituitary tumors: pathophysiology, clinical manifestations and management.

2001 ◽  
pp. 287-305 ◽  
Author(s):  
B M Arafah ◽  
M P Nasrallah
Keyword(s):  
Natural History ◽  
Treatment Options ◽  
Hormone Secretion ◽  
Cranial Nerves ◽  
Clinical Manifestations ◽  
Pituitary Tumors ◽  
Optic Chiasm ◽  
Primary Treatment ◽  
Immunocytochemical Staining ◽  
Tumor Type

Pituitary tumors are frequently encountered intracranial neoplasms. They present with a variety of clinical manifestations that include symptoms and signs of excessive hormone secretion by the tumor, signs of hormone deficits by the normal pituitary gland and others related to expansion of the tumor mass and the resulting compression of surrounding structures such as the optic chiasm and cranial nerves. Advances in molecular biology, immunocytochemical staining and imaging, and the introduction of new treatment options have improved our understanding of the natural history of these adenomas and their management. Available treatments include surgical, medical and radiation therapy. Although the primary treatment for each tumor type may vary, it is important to consider all available options and select the most applicable for that patient. The interaction of all members of management team, including the primary care provider, the endocrinologist and the neurosurgeon in selecting the treatment course can only improve therapeutic outcome. Regardless of the initial choice of treatment,follow-up of all patients should be maintained indefinitely. The managing physician should be familiar with the natural history and long-term complications of pituitary adenomas, and with the side effects of treatments given over the years.

scholarly journals Pituitary apoplexy: clinical features, management and outcome. Clinical study and review of the literature

2015 ◽  
Vol 22 (1) ◽  
pp. 69-77 ◽  
Author(s):  
Adriana Elena Solomon ◽  
Ligia Tataranu ◽  
Vasile Ciubotaru ◽  
Mircea Radu Gorgan
Keyword(s):  
Cavernous Sinus ◽  
Pituitary Apoplexy ◽  
Cranial Nerves ◽  
Optic Chiasm ◽  
Clinical Syndrome ◽  
Rapid Expansion ◽  
Neurological Deficits ◽  
Suprasellar Region ◽  
Level Of Consciousness ◽  
Significant Compression

AbstractBackground: Pituitary apoplexy is a clinical syndrome secondary to rapid expansion of the content of the sella and extension to suprasellar region, cavernous sinus, sphenoid sinus secondary to a bleeding, ischemic or mixed episode taking place in a pituitary adenoma. This episode will determine a significant compression of the optic nerves, optic chiasm, cavernous sinus and hypothalamus, which translates clinically most often by headache, visual disturbances, deceased level of consciousness and ophthalmoplegia. Material and methods: This paper presents a retrospective study over a period of five years, from January 2009 to December 2013 and includes 98 patients diagnosed with pituitary apoplexy and treated in the Third Department of Neurosurgery, Emergency Clinical Hospital Bagdasar-Arseni. Of the 98 patients, 62 were females (63.3 %) and 36 were males (36.7 %) with a ratio of female to male of 1.7:1. The patients were aged between 17 and 75 years old, average age being approximately 50 years. Follow-up period ranged from 2 months to 5 years. The main symptomsat presentation was sudden, intense headache, this symptom was encountered in 90 patients (91.83%), vomiting showed by 76 patients (77.55%), decreased visual acuity observed in 57 patients (58.16%), visual field deficits in 74 patients (75.51%), cranial nerves palsy (III, IV, VI) observed in 14 patients (14.28 %). Conclusions: Pituitary apoplexy is a disease that can endanger patients' lives. The clinical presentation may vary from minor symptoms to major neurological deficits and even death so early diagnosis and treatment are vital.

Human Neurofibromas in Co-Culture with Mouse Neurons

1982 ◽  
Vol 40 ◽  
pp. 194-195
Author(s):  
R.L. Martuza ◽  
T. Liszczak ◽  
A. Okun ◽  
T-Y Wang
Keyword(s):  
Schwann Cell ◽  
Schwann Cells ◽  
Genetic Disorder ◽  
Cranial Nerves ◽  
Sympathetic Nerves ◽  
Acoustic Neuromas ◽  
Spinal Roots ◽  
Neural Crest Origin ◽  
Multiple Abnormalities ◽  
Other Neoplasms

Neurofibromatosis (NF) is an autosomal dominant genetic disorder with a prevalence of 1/3,000 births. The NF mutation causes multiple abnormalities of various cells of neural crest origin. Schwann cell tumors (neurofibromas, acoustic neuromas) are the most common feature of neurofibromatosis although meningiomas, gliomas, and other neoplasms may be seen. The schwann cell tumors commonly develop from the schwann cells associated with sensory or sympathetic nerves or their ganglia. Schwann cell tumors on ventral spinal roots or motor cranial nerves are much less common. Since the sensory neuron membrane is known to contain a mitogenic factor for schwann cells, we have postulated that neurofibromatosis may be due to an abnormal interaction between the nerve and the schwann cell and that this interaction may be hormonally modulated. To test this possibility a system has been developed in which an enriched schwannoma cell culture can be obtained and co-cultured with pure neurons.

Relationship of Optic Chiasm to Sella Turcica and Pituitary Stalk: Correlation of Cadaveric and Imaging Findings

2013 ◽  
Vol 74 (S 01) ◽  
Author(s):  
Christoph Griessenauer ◽  
Joel Raborn ◽  
Martin Mortazavi ◽  
Shane Tubbs
Keyword(s):  
Sella Turcica ◽  
Optic Chiasm ◽  
Pituitary Stalk ◽  
Imaging Findings ◽  
Relationship Of

Hemimegalencephaly: involvement of cranial nerves and intracranial vessels

2013 ◽  
Vol 44 (02) ◽  
Author(s):  
T Bosemani ◽  
E Boltshauser ◽  
M Staudt ◽  
L Flores-Sarnat ◽  
S Bürki ◽  
...  
Keyword(s):  
Cranial Nerves
Sign in / Sign up

Export Citation Format

Share Document