Pituitary Adenoma after the Gamma-Knife Radiosugery: correlation of MRI findings with clinical manifestation

Specific language impairment (SLI) occurs when children present language maturation, at least 12 months behind their chronological age in the absence of sensory or intellectual deficits, pervasive developmental disorders, evident cerebral damage, and adequate social and emotional conditions. The aim of this study was to classify a group of children according to the subtypes of SLI and to correlate clinical manifestations with cortical abnormalities. Seventeen children with SLI were evaluated. Language assessment was based on standardized test (Peabody) and a non-standardized protocol, which included phonological, syntactical, semantical, pragmatical and lexical aspects of language. All children, except one, had abnormal MRI. Thirteen children presented perisylvian polymicrogyria. The MRI findings in the remaining three patients were: right frontal polymicrogyria, bilateral fronto-parietal atrophy, and hypogenesis of corpus callosum with Chiari I. The data show that patients with posterior cortical involvement tended to present milder form of SLI (no sign of articulatory or bucofacial praxis disturbance), while diffuse polymicrogyric perisylvian cortex usually was seen in patients who presented severe clinical manifestation, mainly phonological-syntactic deficit. In conclusion, SLI may be associated with perisylvian polymicrogyria and clinical manifestation may vary according to the extent of cortical anomaly.

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Asymptomatic internal carotid artery occlusion after gamma knife radiosurgery for pituitary adenoma: Report of two cases and review of the literature

Reports of Practical Oncology & Radiotherapy ◽

10.1016/j.rpor.2016.09.006 ◽

2016 ◽

Vol 21 (6) ◽

pp. 555-559 ◽

Cited By ~ 1

Author(s):

Giorgio Spatola ◽

Laura Frosio ◽

Marco Losa ◽

Antonella del Vecchio ◽

Martina Piloni ◽

...

Keyword(s):

Pituitary Adenoma ◽

Carotid Artery ◽

Internal Carotid Artery ◽

Gamma Knife ◽

Internal Carotid ◽

Gamma Knife Radiosurgery ◽

Artery Occlusion ◽

Carotid Artery Occlusion ◽

Internal Carotid Artery Occlusion ◽

Review Of The Literature

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Neurocognitive changes in pituitary adenoma patients after Gamma Knife radiosurgery

Journal of Neurosurgery ◽

10.3171/2018.7.gks181595 ◽

2018 ◽

Vol 129 (Suppl1) ◽

pp. 55-62 ◽

Cited By ~ 3

Author(s):

Alana Tooze ◽

Jason P. Sheehan

Keyword(s):

Pituitary Adenoma ◽

Executive Functions ◽

Gamma Knife ◽

Cushing’S Disease ◽

Transsphenoidal Surgery ◽

Gamma Knife Radiosurgery ◽

Cognitive Outcomes ◽

Cushing's Disease ◽

Immediate Memory ◽

Female Patients

OBJECTIVEPituitary adenomas and the treatment required for the underlying neuropathology have frequently been associated with cognitive dysfunction. However, the mechanisms for these impairments remain the subject of much debate. The authors evaluated cognitive outcomes in patients treated with or without Gamma Knife radiosurgery (GKRS) for an underlying pituitary adenoma.METHODSThis was a retrospective, institutional review board–approved, single-institution study. A total of 51 patients (23 male, 28 female) treated for pituitary adenoma were included in this neurocognitive study. Twenty-one patients underwent GKRS following transsphenoidal surgery, 22 patients were treated with transsphenoidal surgery alone, and eight patients were conservatively managed or were treated with medical management alone. Comparisons using psychometric tests of general intellectual abilities, memory, and executive functions were made between the treatment groups, between male and female patients, and between patients with Cushing’s disease and those with nonfunctioning adenoma (NFA).RESULTSThe entire patient sample, the NFA group, and the GKRS group scored significantly below expected on measures of both immediate and delayed memory, particularly for visually presented information (p ≤ 0.05); however, there were no significant differences between the patients with Cushing’s disease and those with NFA (t ≤ 0.56, p ≥ 0.52). In those who underwent GKRS, memory scores were not significantly different from those in the patients who did not undergo GKRS (t ≤ 1.32, p ≥ 0.19). Male patients across the sample were more likely to demonstrate impairments in both immediate memory (t = −3.41, p = 0.003) and delayed memory (t = −3.80, p = 0.001) than were female patients (t ≤ 1.09, p ≥ 0.29). There were no impairments on measures of general intellectual functioning or executive functions in any patient group. The potential contributions of tumor size and hormone levels are discussed.CONCLUSIONSOverall, pituitary adenoma patients demonstrated relative impairment in anterograde memory. However, GKRS did not lead to adverse effects for immediate or delayed memory in pituitary adenoma patients. Cognitive assessment of pituitary adenoma patients is important in their longitudinal care.

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Endocrine Response after Gamma Knife-Based Stereotactic Radiosurgery for Secretory Pituitary Adenoma

Stereotactic and Functional Neurosurgery ◽

10.1159/000151717 ◽

2008 ◽

Vol 86 (5) ◽

pp. 292-296 ◽

Cited By ~ 28

Author(s):

Brent A. Tinnel ◽

Mark A. Henderson ◽

Thomas C. Witt ◽

Achilles J. Fakiris ◽

Robert M. Worth ◽

...

Keyword(s):

Pituitary Adenoma ◽

Stereotactic Radiosurgery ◽

Gamma Knife ◽

Endocrine Response

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Clinical and pathological analysis of benign brain tumors resected after Gamma Knife surgery

Journal of Neurosurgery ◽

10.3171/2014.8.gks141439 ◽

2014 ◽

Vol 121 (Suppl_2) ◽

pp. 179-187 ◽

Cited By ~ 2

Author(s):

Ali Liu ◽

Jun-Mei Wang ◽

Gui-Lin Li ◽

Yi-Lin Sun ◽

Shi-Bin Sun ◽

...

Keyword(s):

Pituitary Adenoma ◽

Brain Tumors ◽

Gamma Knife ◽

Tumor Recurrence ◽

Surgical Intervention ◽

Mass Effect ◽

Benign Tumors ◽

Tumor Proliferation ◽

Pathological Analysis ◽

Before And After

ObjectThe goal of this study was to assess the clinical and pathological features of benign brain tumors that had been treated with Gamma Knife surgery (GKS) followed by resection.MethodsIn this retrospective chart review, the authors identified 61 patients with intracranial benign tumors who had undergone neurosurgical intervention after GKS. Of these 61 patients, 27 were male and 34 were female; mean age was 49.1 years (range 19–73 years). There were 24 meningiomas, 18 schwannomas, 14 pituitary adenomas, 3 hemangioblastomas, and 2 craniopharyngiomas. The interval between GKS and craniotomy was 2–168 months, with a median of 24 months; for 7 patients, the interval was 10 years or longer. For 21 patients, a craniotomy was performed before and after GKS; in 9 patients, pathological specimens were obtained before and after GKS. A total of 29 patients underwent GKS at the Beijing Tiantan Hospital. All specimens obtained by surgical intervention underwent histopathological examination.ResultsMost patients underwent craniotomy because of tumor recurrence and/or exacerbation of clinical signs and symptoms. Neuroimaging analyses indicated tumor growth in 42 patients, hydrocephalus in 10 patients with vestibular schwannoma, cystic formation with mass effect in 7 patients, and tumor hemorrhage in 13 patients, of whom 10 had pituitary adenoma. Pathological examination demonstrated that, regardless of the type of tumor, GKS mainly induced coagulative necrosis of tumor parenchyma and stroma with some apoptosis and, ultimately, scar formation. In addition, irradiation induced vasculature stenosis and occlusion and tumor degeneration as a result of reduced blood supply. GKS-induced vasculature reaction was rarely observed in patients with pituitary adenoma. Pathological analysis of tumor specimens obtained before and after GKS did not indicate increased tumor proliferation after GKS.ConclusionsRadiosurgery is effective for intracranial benign tumors of small size and deep location and for tumor recurrence after surgical intervention; it is not effective for intracranial tumors with symptomatic mass effect. The radiobiological effects of stereotactic radiosurgery on the benign tumors are mainly caused by cellular and vascular mechanisms. Among the patients in this study, high-dose irradiation did not increase tumor proliferation. GKS can induce primary and secondary effects in tumors, which could last more than 10 years, thereby warranting long-term follow-up after GKS.

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