Case report: three patients presenting with isolated ACTH deficiency caused most likely by hypophysitis, traumatic brain injury and empty sella syndrome v

2013 ◽  
Vol 121 (03) ◽  
Author(s):  
A Müller-Öffner ◽  
I Opherk ◽  
W Sippel ◽  
S Graf ◽  
T Siegmund ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Case Report ◽  
Brain Injury ◽  
Empty Sella ◽  
Empty Sella Syndrome ◽  
Isolated Acth Deficiency ◽  
Acth Deficiency

scholarly journals Hypopituitarism other than sellar and parasellar tumors or traumatic brain injury assessed in a tertiary hospital

2019 ◽  
Vol 35 (4) ◽  
Author(s):  
Sarwar Malik ◽  
Zareen Kiran ◽  
Muhammad Owais Rashid ◽  
Minaz Mawani ◽  
Asma Gulab ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Hospital ◽  
Empty Sella ◽  
University Hospital ◽  
Imaging Data ◽  
Empty Sella Syndrome ◽  
Secondary Hypothyroidism

Objective: Data regarding the etiology, clinical and biochemical patterns in hypopituitarism is scant for Pakistan. We describe the characteristics of patients with hypopituitarism other than sellar and parasellar tumors or traumatic brain injury from a tertiary care center in Pakistan. Methods: We conducted a retrospective descriptive study in the Aga Khan University Hospital, Karachi, Pakistan. We studied all patients presenting with hypopituitarism, between January 2004 and December 2013. Clinical, hormonal and imaging data pertinent to the study was collected according to inclusion criteria. Results: Forty-two patients presented to the endocrinology clinics at the Aga Khan University Hospital during the study period. Thirty-seven patients (88.1%) were females. Mean age ± standard deviation of the participants was 53.8 ± 14.7 years. Sixteen patients had secondary infertility and all were females; a majority of patients in this group had Sheehan’s syndrome (n=8) followed by empty sella syndrome (n=3), partial empty sella syndrome (n=2), idiopathic cause (n=2) and tuberculoma (n=1). Eighteen females (48.6%) reported inability to lactate. Conclusions: Non-traumatic hypopituitarism was more common in women, with Sheehan syndrome being the most common cause of hypopituitarism in our study (35.7%). Secondary hypothyroidism was the most common hormonal deficiency. The most commonly reported symptom was weakness. doi: https://doi.org/10.12669/pjms.35.4.174 How to cite this:Malik S, Kiran Z, Rashid MO, Mawani M, Gulab A, Masood MQ, et al. Hypopituitarism other than sellar and parasellar tumors or traumatic brain injury assessed in a tertiary hospital. Pak J Med Sci. 2019;35(4):---------. doi: https://doi.org/10.12669/pjms.35.4.174 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Clinical Implications of the Center of Balance for a Veteran with Traumatic Brain Injury

2015 ◽  
pp. 280-289
Keyword(s):  
Traumatic Brain Injury ◽  
Case Report ◽  
Brain Injury ◽  
Benign Paroxysmal Positional Vertigo ◽  
Medical Center ◽  
Treatment Plan ◽  
Successful Outcome ◽  
Model Case ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo

Background: It is known that traumatic brain injury (TBI), even of the mild variety, can cause diffuse multisystem neurological damage. Coordination of sensory input from the visual, vestibular and somatosensory pathways is important to obtain proper balance and stabilization in the visual environment. This coordination of systems is potentially disrupted in TBI leading to visual symptoms and complaints of dizziness and imbalance. The Center of Balance (COB) at the Northport Veterans Affairs Medical Center (VAMC) is an interprofessional clinic specifically designed for patients with such complaints. An evaluation entails examination by an optometrist, audiologist and physical therapist and is concluded with a comprehensive rehabilitative treatment plan. The clinical construct will be described and a case report will be presented to demonstrate this unique model. Case Report: A combat veteran with a history of a gunshot wound to the skull, blunt force head trauma and exposure to multiple explosions presented with complaints of difficulty reading and recent onset dizziness. After thorough evaluation in the COB, the patient was diagnosed with and treated for severe oculomotor dysfunction and benign paroxysmal positional vertigo. Conclusion: Vision therapy was able to provide a successful outcome via improvement of oculomotor efficiency and control. Physical therapy intervention was able to address the benign paroxysmal positional vertigo. The specific evaluation and management as pertains to the aforementioned diagnoses, as well as the importance of an interprofessional rehabilitative approach, will be outlined.

Chronic psychiatric changes in a severe post-traumatic brain injury patient

2016 ◽  
Vol 33 (S1) ◽  
pp. S318-S318
Author(s):  
J. Silva ◽  
J. Mota ◽  
P. Azevedo
Keyword(s):  
Traumatic Brain Injury ◽  
Case Report ◽  
Brain Injury ◽  
Social Impairment ◽  
Mood Stabilizers ◽  
Work Related ◽  
Randomized Controlled Studies ◽  
Injury Patient ◽  
Post Traumatic ◽  
Competing Interest

IntroductionSevere traumatic brain injury (TBI) causes neuropsychiatric disturbances. Emotional and personality disturbances seem to cause much more seriously handicap than residual cognitive or physical disabilities. The prognosis may be poor associated with marked social impairment, so a multidisciplinary approach team is required in order to improve patient's quality of life and reintegration in family and society.ObjectivesTo summarize the latest literature about this field and to present a case report.AimTo explore and learn more about chronic psychiatric changes in severe post-traumatic brain injury and share with the scientific community how challenging the approach of this entity can be.MethodsA brief review of the latest literature was performed, using PubMed and the keywords “traumatic brain injury” and “psychiatric changes”. A case report is presented.ResultsAlthough SSRI, benzodiazepines, mood stabilizers and antipsychotics are commonly used, new options are reported such as methylphenidate and cholinesterase inhibitors. The presented patient, a 27-year-old male, began with neuropsychiatric disturbances after a work-related fall from 9 meters high: convulsions and alcohol compulsive drinking. Three years have passed and his changes are still difficult to approach. Besides other medication, such as benzodiazepines and mood stabilizers, flufenazine injections and naltrexone seemed to be determinant in his behaviour and mood stabilization. He is also on a long-term alcoholism programme.ConclusionsAlthough the understanding of TBI-associated neuropsychiatric disorders has improved in the last decade, further research is needed, such as randomized-controlled studies to study new pharmacological and non-pharmacological approach.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Reversible Hypothyroidism in Empty Sella Syndrome: A Case Report.

1998 ◽  
Vol 45 (3) ◽  
pp. 385-391 ◽  
Author(s):  
FUMIO OTSUKA ◽  
TOSHLO OGURA ◽  
NOBUHIKO HAYAKAWA ◽  
SEISHI HARADA ◽  
JINGO KAGEYAMA ◽  
...  
Keyword(s):  
Case Report ◽  
Empty Sella ◽  
Empty Sella Syndrome
Sign in / Sign up

Export Citation Format

Share Document