Symptoms And Treatment Of Pituitary Apoplexy Essay

5. It is expected that after his transsphenoidal hypophysectomy, all of B.J.’s anterior pituitary hormones will be deficient (panhypopituitarism). What type of hormone replacement will be needed?

He also had right more than left mastoid opacifications and states that he was recently treated for otitis media. He has hypertension, hyperlipidemia, coronary disease and had been noncompliant with his medications in the past. His exam was essentially normal except for the subjective vertigo. There was no nystagmus and no diplopia on the initial exam. On 06/19/2015, he gave a different history. He states that he had a strike to the left temporal on Tuesday 06/16/2015. This did not result in any vertigo or any other neurological symptoms at that time. It was two days later that he had the vertigo at work. The patient also claimed that he had been seeing double since the previous night and the morning of the 19th. However, his neurological exam at that time, failed to reveal any actual disconjugate gaze. The patient had an MRI MRA, which revealed old white matter ischemic disease and mild intracranial atherosclerosis, but no evidence for acute stroke or posterior circulation significant stenosis. His diagnosis was labyrinthitis, possibly due to his bilateral mastoiditis. He was treated with Augmentin for 10 days. His symptoms resolved prior to discharge on meclizine. On physical therapy on discharge, he had no

Two pt verifier name/dob confirmed. Informed the pt this a f/u call to address s/p/ pituitary Adenoma. Pt states that is doing much better but he occasional have a headache and stuffy nose. Discuss dc instructions medication, and f/u appt with the pt. Discuss s/s that would warrant the pt to seek medical attention immediately. Encourage the pt f/u with his PCM. During conversation pt request refill on his Synthroid. Informed the pt a courtesy 90 day supply was ordered. Again recommend that he f/u with his provider. Pt refused appt at this time, but states that he will call CAMO to schedule an appt. Pt agrees and verbalized

Surgery offers the best chance of a cure. A neuro-endocrinologist is needed to properly diagnose the condition while a neurosurgeon is needed to perform the surgery. Since the pituitary gland sits inferior to the hypothalamus of the brain, precision in microsurgery is highly necessary. Unfortunately, pituitary adenomas that invade the sella turcica of the brain lower the chances of a successful surgery. Undergoing surgery is always a risk, but this treatment provides the best chances for survival. Medications are also offered as a course of treatment, although proven with a lower success rate. Physicians prescribe monthly injections of somatostatin to help suppress the overproduction of the growth hormone. Although this poses less of a risk than surgery, a reported 70% of patients had an actual decrease in GH hormone. A consequence of using this method is a heavy reliance on drugs for an unforeseeable amount of time. Drugs are often costly so this can pose a problem as well. Radiation therapy is used when all other options have failed. A dose of radiation is targeted on the tumor and the surrounding brain structures are typically left unaffected. 18 months are needed to see a substantial reduction in growth hormone output. Consequences of radiation treatment are delayed pituitary failure, learning disabilities, obesity, and emotional changes (Kleinberg,

Patient is a 19-year-old right-handed white female who is a fair historian. She states that she started having headaches as a child. Her father told her that he also had headaches and that they would eventually go away. She describes having a severe headache, which she calls her first migraine, after softball practice at age 12. Menarche was at age 13 with no change in her headaches. Her headaches have not been menstrually related. There was no clear change in her headaches during pregnancy or in the postpartum period. She states that she gets a dull headache two to three days out of a week. This is in variable locations on her head, but can also be a nuchal. The pain is of variable quality, but it does worsen with exertion. She also gets more

Serum cholesterol rates have been the most reliable means of predicting remission after pituitary surgery to manage Cushing's. However, this study suggests that surgery is not always the best option, and often results in a cyclic form of hypercortisolism.

Per (2004-2006) records and a consultative examination (CE), the claimant reported a history of retinopathy of prematurity that caused right eye blindness since birth and a cataract in the right eye, as well as a visual field restriction (less than 20 degrees), myopia, and poor visual acuity in the left eye that required corrective eyeglasses. She also had a history of asthma and migraine headaches.

The most common, presenting symptom is optic neuritis, which generally involves unilateral visual loss (Béthoux, Fox & Rae-Grant, 2013). Optic neuritis is due to the optic nerve being affected, which is an extension of the brain and contains central CNS myelinated nerves (Murray, 2005). Optic neuritis (inflammation of the optic

12/16/15 Progress Report indicated that the patient wakes up with headaches. She mentioned headache in the frontal vertex or temporal occipital areas. She also feels imbalance. She denies bruxism and has no significant neck symptoms. She reported having some minor neck tightness. She was being treated with acupuncture 2 X per week and craniosacral therapy 2 X per week. She noted that she was able to read better in the past two weeks. She had difficulty scanning a written page in the past. She also mentioned that her insomnia has slightly improved since initiating these 2 therapies. Physical exam showed no palpable spasms in her cervical region over her muscles of mastication. Cervical range of motion: backward flexion 70 degrees and forward flexion 60 degrees. She was able to turn 60 degrees to each side. She is able to tilt 40 degrees to other side. Comments: Based on the absence of objective findings, she has reached a medical end result with no need for any further treatment. No additional treatment or diagnostic testing is

The hypothalamic nucleus, by releasing specific neuro- transmitter peptides, controls the activities of the secretory cells of the anterior lobe of the pituitary body. Hormones released or secreted by cells of the supraoptic and paraventricular nuclei are transported, in the form of granules, to the posterior lobe of the pituitary; from there they are absorbed into the blood stream (Engel, 1997).Under conditions of disease, the neurotransmitter peptides may be quantitatively increased, decreased, or in some way made defective; the neurons that synthesize these peptides or their glandular targets may fail to function or become over active(Ropper, 2002). The nuclei of the hypothalamus are conventionally divided into three paired groups: the anterior group, including the preoptic, supraoptic, and paraventriular nuclei, which are mainly neurohypophysical in their relationships; the middle group, including the tuberal, arcuate, ventrolatural, and dorsal nuclei; and the posterior group including the mammillary and posterior nuclei (Ropper, 2002).The Hypothalamus or hypopysis is divided into two lobes: the anterior, or adenohypophysis, which is derived from the buccal endoderm(Rathke’s pouch),and; the posterior, or neurohypophysis, which forms a diverticulum from the base of the hypothalamus (Bostrom,2003).

A pituitary tumor can cause loss of vision in one or both eyes depending on its size and shape. The pituitary gland sits in the pituitary sella, which is almost directly behind the eye. If the pituitary tumor gets large enough and grows laterally, it can push against the optic nerve and stop the message for getting to the cerebral cortex. An individual with a pituitary tumor will first notice notice dark, blurry, or dim vision. Sometimes it will only affect vision on one side, when it affects both sides of vision, it's pressing against the optic chiasm.

I returned with the Dr. to the exam room. After he examined her retina and assessed his findings (he did agree with the ER Dr.), he explained the signs and symptoms were leading him to believe she was suffering from Charles Bonnet Syndrome. He continued to explain what she was experiencing, (CBS), could be associated with her macular degeneration. Her visions can be a normal reaction or part of her vision loss. What she was experiencing was by no means a mental health problem. The sooner the caregivers and her family understand this is normal to her eye disease, the sooner everyone involved will be able to experience calmer days, especially the patient. The Dr. shared that there were not any known treatments nor medications to help with this part of the patient’s vision loss. The best treatment and medication is the understanding and reassurances of everyone involved with the patient. He did suggest the patient keep her next scheduled appointment, with the understanding to call the office to report any changes in vision, if any. I gave the family a printout about CBS and the Dr. advised the family to research for more information. He also

The pituitary gland is responsible for several important hormones that control some of the major body functions such as reproduction, growth and development, and metabolism. The majority of cases are caused by a benign tumor on the pituitary gland, which causes excessive amounts of the growth hormone to be secreted causing the many symptoms of acromegaly. Depending on the size and location of the tumor, some may press on surrounding parts of the brain causing some of the symptoms of acromegaly including impaired vision and headaches. Rarely, this disorder can be caused by a non-pituitary tumor such as a tumor located in the lungs, pancreas, adrenal glands, or other parts of the brain. Depending on the case, sometimes the tumor actually secretes the extra growth hormone. In other cases the tumor may produce a hormone called the growth hormone-releasing hormone (GH-RH), which then stimulates the pituitary to release growth

A 31 year old male presented to the outpatient department of the University Hospital of the West Indies with a one year history of weakness of the upper limbs that had been affecting his function at school. He was also complaining of headaches that were located mostly over the frontal area of the head and were aggravated by sneezing and coughing. He denied any vertigo, vomiting, lateralising weakness, fever or neck stiffness. On examination, he had a Glasgow Coma Score (GCS) of 15 with no cranial nerve deficits. No cerebellar signs were elicit, he however had grade IV/V

OBJECTIVE: The aim of this study was to report the results of a consecutive series of patients undergoing pituitary surgery using a pure endoscopic endonasal approach and to evaluate the efficacy and safety of this procedure.