Additional Topics: Neuroanesthesia

Anesthesiology Applied Exam Board Review ◽

10.1093/med/9780190852474.003.0036 ◽

2018 ◽

pp. 249-254

Author(s):

Ruchir Gupta

Keyword(s):

Multiple Sclerosis ◽

Growth Hormone ◽

Peripheral Neuropathy ◽

Electroconvulsive Therapy ◽

Pituitary Tumor ◽

Anesthetic Management ◽

Intracranial Tumor ◽

Turp Syndrome ◽

Is Evaluation ◽

Triple H

In this chapter several topics related to neuroanesthesia are discussed. Subtopics include management of a partially ruptured cerebral aneurysm, resection of an intracranial tumor, and pathogenesis of autonomic hyperreflexia. Also addressed is triple H therapy for cerebral vasospasm. Ways of preventing transurethral retrograde prostatectomy (TURP) syndrome are presented. Concerns regarding resection of a growth hormone–secreting pituitary tumor are also discussed. Lithium therapy is addressed in the context of electroconvulsive therapy. Anesthetic management in a patient with hyponatremia is discussed, as is evaluation of peripheral neuropathy. Precautions to prevent exacerbation of multiple sclerosis symptoms are outlined. Each scenario is presented as a short, three- to four-question additional topic.

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Association of pituitary adenoma with neuronal christoma: A TEM study

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s042482010016889x ◽

1994 ◽

Vol 52 ◽

pp. 232-233

Author(s):

Eva Horvath ◽

Kalman Kovacs ◽

B. W. Scheithauer ◽

R. V. Lloyd ◽

H. S. Smyth

Keyword(s):

Growth Hormone ◽

Pituitary Adenoma ◽

Pituitary Tumor ◽

Nervous Tissue ◽

Alternative Explanation ◽

Growth Hormone Releasing Hormone ◽

Cell Hyperplasia ◽

Releasing Hormone ◽

Secretory Neurons

The association of a pituitary adenoma with nervous tissue consisting of neuron-like cells and neuropil is a rare abnormality. In the majority of cases, the pituitary tumor is a chromophobic adenoma, accompanied by acromegaly. Histology reveals widely variable proportions of endocrine and nervous tissue in alternating or intermingled patterns. The lesion is perceived as a composite one consisting of two histogenetically distinct parts. It has been suggested that the neuronal component, morphologically similar to secretory neurons of the hypothalamus, may initiate adenoma formation by releasing stimulatory substances. Immunoreactivity for growth hormone releasing hormone (GRH) in the neuronal component of some cases supported this view, whereas other findings such as consistent lack of growth hormone (GH) cell hyperplasia in the lesions called for alternative explanation.Fifteen tumors consisting of a pituitary adenoma and a neuronal component have been collected over a 20 yr. period. Acromegaly was present in 11 patients, was equivocal in one, and absent in 3.

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Growth hormone gene transcription is regulated by thyroid and glucocorticoid hormones in cultured rat pituitary tumor cells.

Journal of Biological Chemistry ◽

10.1016/s0021-9258(18)33808-0 ◽

1982 ◽

Vol 257 (19) ◽

pp. 11627-11632 ◽

Cited By ~ 39

Author(s):

S R Spindler ◽

S H Mellon ◽

J D Baxter

Keyword(s):

Growth Hormone ◽

Tumor Cells ◽

Gene Transcription ◽

Pituitary Tumor ◽

Growth Hormone Gene ◽

Glucocorticoid Hormones ◽

Rat Pituitary ◽

Rat Pituitary Tumor Cells

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Successful Anesthetic Management of Morbidly Obese Patients During Electroconvulsive Therapy With the ProSeal Laryngeal Mask Airway in a Head-up Position

Journal of Ect ◽

10.1097/yct.0000000000000415 ◽

2017 ◽

Vol 33 (3) ◽

pp. e30-e31 ◽

Cited By ~ 1

Author(s):

Yukihide Koyama ◽

Hiroko Nishioka ◽

Takehiro Ibaraki ◽

Atsushi Ozawa ◽

Naoko Kamoshida ◽

...

Keyword(s):

Laryngeal Mask Airway ◽

Electroconvulsive Therapy ◽

Anesthetic Management ◽

Proseal Laryngeal Mask Airway ◽

Laryngeal Mask ◽

Morbidly Obese ◽

Obese Patients

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Peripheral neuropathy in multiple sclerosis: a clinical and electrophysiologic study

Acta Neurologica Scandinavica ◽

10.1111/j.1600-0404.1995.tb06996.x ◽

1995 ◽

Vol 91 (4) ◽

pp. 234-238 ◽

Cited By ~ 32

Author(s):

I. Sarova-Pinhas ◽

A. Achiron ◽

R. Gilad ◽

Y. Lampl

Keyword(s):

Multiple Sclerosis ◽

Peripheral Neuropathy ◽

Electrophysiologic Study

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Growth Hormone Therapy Does Not Increase the Risk of Craniopharyngioma and Nonfunctioning Pituitary Adenoma Recurrence

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa089 ◽

2020 ◽

Vol 105 (5) ◽

pp. 1573-1580

Author(s):

Marco Losa ◽

Laura Castellino ◽

Angela Pagnano ◽

Alessandro Rossini ◽

Pietro Mortini ◽

...

Keyword(s):

Growth Hormone ◽

Pituitary Adenoma ◽

Growth Hormone Deficiency ◽

Replacement Therapy ◽

Pituitary Tumor ◽

Tumor Recurrence ◽

Hormone Deficiency ◽

Rhgh Therapy ◽

Adult Growth ◽

Rhgh Treatment

Abstract Context Recombinant human growth hormone (rhGH) replacement therapy is often prescribed in patients with nonfunctioning pituitary adenoma (NFPA) or craniopharyngioma, Objective To study whether rhGH therapy in patients with adult growth hormone deficiency (AGHD) increases the risk of pituitary tumor recurrence. Design Retrospective, observational study. Setting Tertiary care center. Patients We studied 283 consecutive patients with AGHD due to NFPA or craniopharyngioma between 1995 and 2018. Intervention rhGH treatment at standard doses was initiated in 123 patients (43.5%). The remaining 160 patients served as controls. Main Outcome Measure Risk of tumor recurrence in rhGH-treated and control patients. Results In univariate analysis, recurrence of the pituitary tumor was less frequent in rhGH-treated patients (19.5%) than in controls (29.7%; hazard ratio [HR] 0.53, 95% confidence interval [CI] 0.32–0.86; P = .01). Multivariate Cox analysis demonstrated that the risk of tumor recurrence was associated with detection of residual disease at the baseline magnetic resonance imaging (HR 9.17; 95% CI, 4.88–17.22; P < .001) and not having performed radiotherapy (HR 16.97; 95% CI, 7.55–38.16; P < .001), while rhGH treatment was no longer associated with a lower risk of recurrence (HR 0.82; 95% CI, 0.47–1.44; P = .50). Conclusions We found no association between rhGH replacement and the risk of tumor recurrence in patients with AGHD caused by NFPA or craniopharyngioma. These data add to the mounting evidence that rhGH therapy has a neutral effect on the recurrence of pituitary tumors. Précis Replacement therapy with rhGH is prescribed to patients with adult growth hormone deficiency. Our study found no increased risk of pituitary tumor recurrence.

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