Follow-up study with computerized tomography and clinical evaluation 5 to 10 years after surgery for pituitary adenoma

1980 ◽  
Vol 53 (2) ◽  
pp. 144-148 ◽  
Author(s):  
Carin Muhr ◽  
Kjell Bergstrom ◽  
Paul Enoksson ◽  
Rune Hugosson ◽  
Per Olov Lundberg
Keyword(s):  
Pituitary Adenoma ◽  
Computerized Tomography ◽  
No Value ◽  
Content Type ◽  
Follow Up Study ◽  
Field Defect ◽  
Very High ◽  
Suprasellar Extension ◽  
Fine Print

✓ This study was based on 24 consecutive patients operated on for pituitary adenoma with suprasellar extension, and treated postoperatively with radiotherapy. The follow-up period was 5 to 10 years. A clinical examination, endocrine evaluation, perimetry, computerized tomography (CT) and sellar roentgenography were performed in 19 of 20 surviving patients. The CT scans revealed four recurrences, while perimetry only showed an increased visual field defect in one patient. Plain sellar films were of no value for diagnosis of recurrence. Prolactin determinations seemed to have a limited value in recurrence diagnosis, but very high levels spoke in favor of a recurrence. Thus, CT was found to be the superior method of diagnosing recurrences. It is proposed that CT be used regularly in the follow-up study of patients operated on for a pituitary adenoma.

An analysis of follow-up results of 1000 intracranial saccular aneurysms with definitive surgical treatment

1979 ◽  
Vol 50 (2) ◽  
pp. 152-157 ◽  
Author(s):  
Takashi Yoshimoto ◽  
Keita Uchida ◽  
Uichi Kaneko ◽  
Takamasa Kayama ◽  
Jiro Suzuki
Keyword(s):  
Surgical Treatment ◽  
Postoperative Results ◽  
Content Type ◽  
Poor Condition ◽  
Follow Up Study ◽  
Normal Life ◽  
Definitive Surgery ◽  
Fine Print ◽  
Saccular Aneurysms

✓ The authors report a follow-up review of 1000 cases of intracranial definitive surgery for saccular aneurysms. The prognosis for such surgical cases is discussed. Postoperative results at least 6 months after discharge from the hospital were analyzed in 876 (93.3%) of the 939 surviving patients. The longest follow-up period was 14 years and 5 months, with an average of 3 years and 7 months. At the time of discharge, there were 543 excellent results, 186 good, 117 fair, 93 poor, and 61 deaths. The chief findings were as follows: 1) Most of the patients determined as “excellent” or “good” at discharge were able to return to normal life; most of the deaths or instances of worsened condition found in the follow-up study were due to new lesions. 2) Fully 62% of the cases determined as “fair” at discharge were found in an improved state at the follow-up study, having returned to normal life. 3) Only 19% of cases determined as “poor” at discharge had improved to the point where a return to normal life was possible, the majority having died or remaining in poor condition.

Ossification of autologous pericranium used in duraplasty

2001 ◽  
Vol 95 (2) ◽  
pp. 350-352 ◽  
Author(s):  
Devon A. Hoover ◽  
Asim Mahmood
Keyword(s):  
Computerized Tomography ◽  
Gunshot Wound ◽  
Osteogenic Potential ◽  
Review Of The Literature ◽  
Content Type ◽  
Dural Closure ◽  
The Many ◽  
Tomography Scanning ◽  
Fine Print

✓ Pericranium is frequently used in duraplasty and is considered superior to the many other alternatives because of its easy availability and because it offers a watertight dural closure while minimizing the problems of adhesion, infection, and rejection. Although the osteogenic potential of all periosteal tissues is recognized, a review of the literature did not reveal a reported case of osseous formation following use of pericranium for duraplasty. The authors report the case of a 17-year-old man who presented with a self-inflicted gunshot wound to the head. He was obtunded, but moving all extremities purposefully. Computerized tomography scanning demonstrated bifrontal injury. A bicoronal craniotomy with debridement was performed on an emergency basis, with vascularized pericranium used for a duraplasty. Follow-up cranioplasty demonstrated significant ossification of the pericranium 5 months after the original surgery. Pericranium is an attractive material for duraplasty; however, its osteogenic potential may interfere with future cranioplasty and cosmesis. This may be especially relevant in young persons.

Serum prolactin in patients with hypothalamus and pituitary disorders

1981 ◽  
Vol 55 (2) ◽  
pp. 194-199 ◽  
Author(s):  
Per Olov Lundberg ◽  
Per Olof Osterman ◽  
Leif Wide
Keyword(s):  
Pituitary Adenoma ◽  
Pituitary Adenomas ◽  
Single Case ◽  
Geometric Mean ◽  
High Serum ◽  
Serum Prolactin ◽  
Content Type ◽  
Sellar Tumor ◽  
Very High ◽  
Fine Print

✓ Serum prolactin concentrations were studied in 115 patients with anatomically defined disorders in the hypothalamo-pituitary region. Fifty of the patients had expansively growing pituitary adenomas; in 17 of them (13 females and four males) the prolactin values were slightly raised (15 to 100 µg/liter), and in 13 (11 females and two males) they were over 100 µg/liter. The frequency of elevated prolactin values was higher for females than for males. Fifteen patients with invasively growing pituitary adenomas had very high serum prolactin levels (range 1230 to 31,500 µg/liter, geometric mean 3150 µg/liter). In a single case of malignant pituitary adenoma, the serum prolactin was at the lower level of detection. Of 49 further patients with suprasellar meningiomas, craniopharyngiomas, or other expansive or destructive lesions of the hypothalamus and sellar region, 15 had slightly raised prolactin values (maximum 114 µg/liter). Eight of these 49 patients had sellar destruction, with a roentgenological picture similar to that in patients with invasive pituitary adenomas. Among these eight patients, the maximum prolactin value was 67 µg/liter. It is concluded that moderately raised serum prolactin values (up to 100 µg/liter) in a patient with a sellar tumor does not prove that the tumor is a prolactinoma. A serum prolactin value of 100 to 1000 µg/liter strongly indicates a prolactin-producing tumor. In a patient with sellar destruction, a serum prolactin value of over 1000 µg/liter is proof that the destruction is caused by an invasive pituitary adenoma.

Lymphocytic adenohypophysitis of pregnancy simulating a pituitary adenoma: a distinct pathological entity

1982 ◽  
Vol 56 (1) ◽  
pp. 148-153 ◽  
Author(s):  
David S. Baskin ◽  
Jeannette J. Townsend ◽  
Charles B. Wilson
Keyword(s):  
Pituitary Adenoma ◽  
Lymphocytic Infiltration ◽  
Optic Chiasm ◽  
Temporal Relation ◽  
Temporal Association ◽  
Pituitary Mass ◽  
Content Type ◽  
Lymphocytic Adenohypophysitis ◽  
Suprasellar Extension ◽  
Fine Print

✓ Diffuse lymphocytic infiltration of the adenohypophysis occurring in temporal relation to pregnancy was found in two patients, each of whom had an intasellar mass with suprasellar extension that caused compression of the optic chiasm. The pathology and etiology of this lesion is discussed. This entity should be considered when evaluating patients with a pituitary mass lesion that presents in temporal association to pregnancy, particularly if there is evidence of hypopituitarism rather than a hypersecreting, endocrineactive adenoma.

Long-term results after lateral canthal advancement for unilateral coronal synostosis

1992 ◽  
Vol 76 (3) ◽  
pp. 401-407 ◽  
Author(s):  
Helio R. Machado ◽  
Harold J. Hoffman
Keyword(s):  
Continuous Improvement ◽  
Long Term Results ◽  
Successful Result ◽  
Content Type ◽  
Follow Up Study ◽  
Coronal Synostosis ◽  
Sick Children ◽  
Fine Print

✓ The procedure of lateral canthal advancement was carried out to correct unilateral coronal synostosis in 39 consecutive patients at The Hospital for Sick Children during a 20-year period. Thirty-seven children were available for follow-up study, and results were considered to be good or excellent in 81% of them. Liberation of the supraorbital margin and release of stenotic skull base sutures are crucial for a successful result. The severity of the process and the age of the patient were not restrictive factors in regard to indication for this procedure. Some patients showed a continuous improvement with time. Morbidity was minimal. It is suggested that lateral canthal advancement is the procedure of choice for unilateral coronal synostosis.

Reinforcement with gauze wrapping for ruptured aneurysms of the middle cerebral artery

1977 ◽  
Vol 47 (6) ◽  
pp. 828-832 ◽  
Author(s):  
Julien C. Taylor ◽  
Abdur R. Choudhury
Keyword(s):  
Mortality Rate ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Recurrent Hemorrhage ◽  
Content Type ◽  
Mortality And Morbidity ◽  
Ruptured Aneurysms ◽  
Follow Up Study ◽  
Fine Print

✓ A 2- to 15-year follow-up study is presented of a series of 35 consecutive patients treated for ruptured aneurysms of the middle cerebral artery by reinforcement with gauze wrapping. Only one patient suffered early recurrent hemorrhage in the postoperative period, and none had a late hemorrhage. The procedure carried a relatively low mortality rate (8.6%). Morbidity was the direct sequel of preoperative conditions. Wrapping is an effective and safe treatment of these aneurysms, with a low mortality and morbidity, and freedom from occlusive infarcts.

Incidence and risk factors for the growth of unruptured cerebral aneurysms: observation using serial computerized tomography angiography

2004 ◽  
Vol 101 (6) ◽  
pp. 908-914 ◽  
Author(s):  
Shunji Matsubara ◽  
Hiromu Hadeishi ◽  
Akifumi Suzuki ◽  
Nobuyuki Yasui ◽  
Hiromi Nishimura
Keyword(s):  
Risk Factors ◽  
Computerized Tomography ◽  
Cerebral Artery ◽  
Maximum Diameter ◽  
Content Type ◽  
Computerized Tomography Angiography ◽  
Unruptured Intracranial Aneurysms ◽  
Aneurysm Growth ◽  
Fine Print

Object. The goal of this study was to examine the growth of unruptured intracranial aneurysms with the focus on the risk factors and incidence of these lesions. Methods. One hundred sixty-six untreated cerebral saccular aneurysms were analyzed in 140 patients. The age of the patients ranged from 29 to 82 years (mean 62.8 years), the female/male ratio was 94:46, and the mean follow-up period was 17.7 months. Aneurysms were located at the internal carotid artery (ICA) in 68 patients, the middle cerebral artery (MCA) in 43, the anterior cerebral artery in 38, the basilar artery (BA) in 13, and the vertebral artery in four patients. The maximum diameter of the lesions ranged from 2 to 20 mm (mean 4.1 mm). All patients were examined using serial computerized tomography angiography to evaluate signs of aneurysm growth. Although growth was identified in 10 aneurysms (nine patients [6.4%]), no bleeding occurred. Growth-related changes were significantly associated with the size of the aneurysm and occurred in three (2.4%) of 125 aneurysms measuring 2 to 4 mm, three (9.1%) of 33 lesions measuring 5 to 9 mm, and four (50%) of eight lesions measuring 10 to 20 mm. These changes were more frequently found in aneurysms located at the BA bifurcation (two [40%] of five lesions) and the ICA (six [8.8%] of 68 lesions) than in those located at the MCA (zero of 43 lesions, p < 0.05). The 1-, 2-, and 3-year cumulative growth rates calculated using the Kaplan—Meier method were 2.5, 8, and 17.6%, respectively. Conclusions. A diameter of at least 10 mm and a location at the BA bifurcation or the ICA were significant risk factors for aneurysm growth. The incidence of growth was 2.5% in the 1st year and this risk increased yearly. Computerized tomography angiography is useful for follow up of patients with aneurysms because it allows the detection of even subtle morphological changes.

Spontaneous reduction in size of prolactin-producing adenoma after delivery

1985 ◽  
Vol 63 (6) ◽  
pp. 973-974 ◽  
Author(s):  
Masahito Fujimoto ◽  
Eiji Yoshino ◽  
Norihiko Mizukawa ◽  
Kimiyoshi Hirakawa
Keyword(s):  
Growth Rate ◽  
Pregnant Woman ◽  
Pituitary Adenoma ◽  
Computerized Tomography ◽  
Tumor Size ◽  
Signs And Symptoms ◽  
Content Type ◽  
Spontaneous Reduction ◽  
Neurological Signs ◽  
Fine Print

✓ The authors describe the case of a pregnant woman with a large prolactin-producing pituitary adenoma that regressed after delivery. The patient's neurological signs and symptoms spontaneously disappeared soon after delivery without treatment. Reduction in tumor size was confirmed on computerized tomography scans. It is hypothesized that the growth rate of a prolactinoma may be accelerated by estrogen.

Computerized tomography of a sellar spine

1982 ◽  
Vol 57 (3) ◽  
pp. 407-409 ◽  
Author(s):  
David L. LaMasters ◽  
James E. Boggan ◽  
Charles B. Wilson
Keyword(s):  
Pituitary Adenoma ◽  
High Resolution ◽  
Pituitary Gland ◽  
Ct Scan ◽  
Computerized Tomography ◽  
Radiographic Appearance ◽  
Content Type ◽  
High Resolution Ct ◽  
Developmental Variant ◽  
Fine Print

✓ A presumed developmental variant of the dorsum sellae was found in a patient undergoing evaluation for a suspected pituitary adenoma. An initial computerized tomography (CT) scan suggested a suprasellar mass; however, high-resolution CT with reformations clearly revealed the mass to be the pituitary gland, which was deformed and displaced upward by an osseous spine projecting from the dorsum sellae. The radiographic appearance and etiology of this anomaly are discussed. Neurosurgeons and neuroradiologists should be aware of this anomaly when evaluating a patient for pituitary adenoma.

Revision of anterior cervical pseudarthrosis with anterior allograft fusion and plating

1997 ◽  
Vol 86 (6) ◽  
pp. 969-974 ◽  
Author(s):  
Domagoj Coric ◽  
Charles L. Branch ◽  
Jeffrey D. Jenkins
Keyword(s):  
Computerized Tomography ◽  
Intraoperative Complications ◽  
Photon Emission ◽  
Surgical Morbidity ◽  
Content Type ◽  
Focal Uptake ◽  
Anterior Plating ◽  
Plate System ◽  
Fine Print

U Anterior cervical discectomy and fusion is an efficacious procedure used to treat a variety of cervical spinal disorders, including spondylosis, myelopathy, herniated discs, trauma, and degenerative disc disease. Pseudarthrosis, or failure of fusion, may be the most common complication of spinal fusion procedures. Nineteen consecutive patients with symptomatic pseudarthrosis following failed anterior cervical fusions were treated with anterior cervical revision using iliac crest allografts and either the Cervical Spine Locking Plate system (10 patients) or the Trapezial Osteosynthetic Plate system (nine patients). The mean age of the nine men and 10 women undergoing treatment was 49.1 years (range 25–72 years). Eleven patients (57.9%) exhibited pseudarthrosis at one level, six (31.5%) at two levels, and two (10.5%) at three levels. The indications for revision were intractable neck pain with radiculopathy (17 patients) or myelopathy (two patients), with evidence of pseudarthrosis on plain cervical radiography as well as computerized tomography (CT) or single-photon emission computerized tomography (SPECT) scanning, or both. All eight patients evaluated with SPECT showed increased focal uptake consistent with pseudarthrosis, which was subsequently confirmed intraoperatively in all eight. The average follow-up period was 22.4 months (range 12–42 months). Solid osseous fusion was achieved over all 28 levels in all 18 patients available for follow-up review (100%). One patient died 4 months postoperatively from myocardial infarction related to preexisting coronary artery disease. There were no intraoperative complications; postoperatively, two patients (10.5%) experienced transient hoarseness. Anterior revision of failed cervical fusions using allograft interbody fusion material and anterior plating is a safe and efficacious procedure. In this series, the use of allografts avoided donor site morbidity without adversely affecting fusion rates. Rigid internal fixation was achieved by means of anterior plating without increasing surgical morbidity rates. The SPECT imaging technique has the potential to reliably confirm the diagnosis of pseudarthrosis.

Sign in / Sign up

Export Citation Format

Share Document