Factors predicting neuro-endocrine recovery following transsphenoidal surgery in pituitary apoplexy patients

2021 ◽  
Author(s):  
Chin Taweesomboonyat ◽  
Thakul Oearsakul
Keyword(s):  
Transsphenoidal Surgery ◽  
Pituitary Apoplexy

scholarly journals Visual Acuity Outcome in Patients with Acute Pituitary Apoplexy after Hyperacute Transsphenoidal Surgery

2018 ◽  
Vol 79 (S 01) ◽  
pp. S1-S188
Author(s):  
Nadine Ibrahim ◽  
Todd Hollon ◽  
Jonathan Trobe ◽  
Ariel Barkan ◽  
Stephen Sullivan ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Transsphenoidal Surgery ◽  
Pituitary Apoplexy

scholarly journals Metastasis of a Dorsal Melanoma to a Pituitary Adenoma Mimicking Pituitary Apoplexy

2017 ◽  
Vol 36 (04) ◽  
pp. 238-242
Author(s):  
Rui Ramos ◽  
Maria Machado ◽  
Cristiano Antunes ◽  
Vera Fernandes ◽  
Olinda Marques ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Pituitary Adenoma ◽  
Adjuvant Radiotherapy ◽  
Transsphenoidal Surgery ◽  
Pituitary Apoplexy ◽  
Clinical Presentation ◽  
Pituitary Macroadenoma ◽  
Histology Result ◽  
History Of ◽  
Transcranial Approach

AbstractMetastases to pituitary adenomas are very rare. From the 20 cases found in the literature, none originated from a cutaneous melanoma. We present the case of a 67-year-old man with a history of transcranial approach to treat a pituitary macroadenoma followed by adjuvant radiotherapy. Fifteen years later, he presented a dorsal nodular melanoma, and three years after that, he developed symptoms of pituitary apoplexy. He was submitted to transsphenoidal surgery, and the histology result revealed metastasis of the melanoma into a pituitary adenoma.The similarity in the clinical presentation of the two entities—pituitary apoplexy and metastasis of the melanoma into a pituitary adenoma—and the rarity of this type of metastization alert to challenges in the differential diagnosis that may confound the neurosurgeon's decision.

Thickening of sphenoid sinus mucosa during the acute stage of pituitary apoplexy

2001 ◽  
Vol 95 (5) ◽  
pp. 897-901 ◽  
Author(s):  
Kazunori Arita ◽  
Kaoru Kurisu ◽  
Atushi Tominaga ◽  
Kazuhiko Sugiyama ◽  
Fusao Ikawa ◽  
...  
Keyword(s):  
Transsphenoidal Surgery ◽  
Sphenoid Sinus ◽  
Pituitary Apoplexy ◽  
Sella Turcica ◽  
Acute Stage ◽  
Mr Images ◽  
Content Type ◽  
Subepithelial Layer ◽  
Sinus Mucosa ◽  
Fine Print

✓ The authors treated two patients with pituitary apoplexy in whom magnetic resonance (MR) images were obtained before and after the episode. Two days after the apoplectic episodes, MR imaging demonstrated marked thickening of the mucosa of the sphenoid sinus that was absent in the previous studies. The relevance of this change in the sphenoid sinus was investigated. Retrospective evaluations were performed using MR images obtained in 14 consecutive patients with classic pituitary apoplexy characterized by acute onset of severe headache. The mucosa of the sphenoid sinus had thickened predominantly in the compartment just beneath the sella turcica, in nine of 11 patients, as ascertained on MR images obtained within 7 days after the onset of apoplectic symptoms. This condition improved spontaneously in all four patients who did not undergo transsphenoidal surgery. The sphenoid sinus mucosa appeared to be normal on MR images obtained from three patients at the chronic stage (> 3 months after onset). The incidence of sphenoid sinus mucosal thickening during the acute stage was significantly higher in the patients with apoplexy than that in the 100 patients without apoplexy. A histological study conducted in four patients who underwent transsphenoidal surgery during the early stage showed that the subepithelial layer of the sphenoid sinus mucous membrane was obviously swollen. The sphenoid sinus mucosa thickens during the acute stage of pituitary apoplexy. This thickening neither indicates infectious sinusitis nor rules out the choice of the transsphenoidal route for surgery.

Postoperative Neurologic Outcome in Patients with Pituitary Apoplexy After Transsphenoidal Surgery

2018 ◽  
Vol 111 ◽  
pp. e18-e23 ◽  
Author(s):  
Young-Hoon Kim ◽  
Young Hyun Cho ◽  
Seok Ho Hong ◽  
Jeong Hoon Kim ◽  
Min-Seon Kim ◽  
...  
Keyword(s):  
Transsphenoidal Surgery ◽  
Pituitary Apoplexy ◽  
Neurologic Outcome

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

2020 ◽  
Vol 137 ◽  
pp. e366-e372
Author(s):  
Dhiraj J. Pangal ◽  
Kelsi Chesney ◽  
Zoe Memel ◽  
Phillip A. Bonney ◽  
Ben A. Strickland ◽  
...  
Keyword(s):  
Transsphenoidal Surgery ◽  
Pituitary Apoplexy ◽  
Case Series ◽  
Endoscopic Endonasal ◽  
Tertiary Center ◽  
Endoscopic Endonasal Transsphenoidal Surgery

scholarly journals P.085 Perioperative endovascular procedure utilization in transsphenoidal surgery patients at two tertiary-care academic centres

2019 ◽  
Vol 46 (s1) ◽  
pp. S36
Author(s):  
TJ Huynh ◽  
M Cusimano ◽  
DB Clarke ◽  
A Weeks ◽  
TR Marotta ◽  
...  
Keyword(s):  
Vascular Injury ◽  
Transsphenoidal Surgery ◽  
Endovascular Procedures ◽  
Pituitary Apoplexy ◽  
Critical Role ◽  
Tertiary Care ◽  
Operative Procedures ◽  
Parent Artery ◽  
Balloon Test Occlusion ◽  
Aneurysm Coiling

Background: Utilization of endovascular procedures in the perioperative management of patients undergoing transsphenoidal surgery is uncommon but plays a critical role in preventing and treating potentially life-threatening vascular complications. Methods: We performed a retrospective review of all patients over a 10-year period who underwent transsphenoidal surgery at two tertiary-care institutions and identified all pre-operative and post-operative endovascular procedures performed. Results: 18 perioperative endovascular procedures were performed including 9 pre- and 9 post-operative. Pre-operative procedures included balloon-test occlusion (n=4), aneurysm coiling (n=4), and parent artery occlusion (n=1). One aneurysm coiling was complicated by coil migration requiring coil retrieval with a snare device and one balloon-test occlusion was complicated by pituitary apoplexy. Pituitary apoplexy following balloon-test occlusion has not been reported and the potential pathophysiology is reviewed. Post-operative procedures included embolization for epistaxis (n=2) and embolization with or without parent artery sacrifice for carotid and anterior cerebral artery vascular injury (n=7). Arterial vascular injury was managed with coil embolization and/or with detachable balloons. Review of anatomical features predisposing to vascular injury are discussed. Conclusions: Patients undergoing transsphenoidal surgery should be managed with a multidisciplinary team ensuring that endovascular treatment options are made available during the perioperative period.

Spontaneous Postoperative Normalization of Growth Hormone Levels in Two Patients with Acromegaly Not Cured by Transsphenoidal Surgery

Neurosurgery ◽  
1988 ◽  
Vol 23 (5) ◽  
pp. 634-637 ◽  
Author(s):  
A. M. Landolt ◽  
E. R. Froesch ◽  
M. P. König
Keyword(s):  
Growth Hormone ◽  
Transsphenoidal Surgery ◽  
Pituitary Apoplexy ◽  
The Other ◽  
Preoperative Treatment ◽  
Intratumoral Hemorrhage ◽  
Transsphenoidal Operation ◽  
Adenoma Tissue ◽  
Long Acting ◽  
Serum Gh

Abstract Postoperative persistence of elevated growth hormone (GH) levels in patients with acromegaly usually suggests residual adenoma tissue secreting GH and is an indication for further treatment. In rare cases, spontaneous normalization of serum GH levels in patients with acromegaly has been reported to occur as a consequence of intratumoral hemorrhage (pituitary apoplexy). We report two patients in whom persisting acromegaly was documented 1 and 2 weeks, respectively, after transsphenoidal operation and who experienced spontaneous normalization of GH levels. In one patient, this favorable outcome was found 1.5 years after the operation and followed a pregnancy. The other patient, whose GH values normalized 3 months after operation, had received preoperative treatment with a new, long-acting somatostatin analog.

Sign in / Sign up

Export Citation Format

Share Document