Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Six patients suffering from cystic hypophysoma and one from craniopharyngioma treated with intracavitary radiation by colloidal 32P transnasophenoid injection were studied. After injection, the headache was eliminated and vision improved in all cases, visual field enlarged in 4, and sexuality improved in 5 male cases. All the patients recovered their normal daily life and work in 2-12 year's follow-up period. The conclusion is that the above mentioned therapy is simple, safe and effective.
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PMID:[A long-term observation on cystic hypophysoma and craniopharyngioma treated by colloidal 32P transnasosphenoid injection]. 821 98

81 patients with expansive lesion in the optic chiasm region were reviewed. Pituitary adenomas were diagnosed in 37 patients: 5 with acromegaly, 2 with prolactinoma and the remaining 30 with hormone inactive adenomas. Meningiomas were diagnosed in 39, craniopharyngiomas in 4 patients and chordoma in one patient. The most common symptom was visual disturbance in 86%, but headache, hormonal disturbance occurred as well. All patients with adenomas were endocrinologically evaluated after detailed ophthalmologic and neurologic examinations. 28 patients were transcranially operated, 5 transsfenoidally and transcranially and 4 only transfenoidally. After endocrinologic reevaluation all patients with adenomas had undergone postoperative radiotherapy. Tumor recurrence was diagnosed in 14 patients, while 6 patients underwent reoperation. The approach to surgical regimen depended on the size and localization of meningioma. Unilateral subfrontal approach was most frequent (35). Subtotal tumor ablation was performed in 5 (13%) patients. Craniopharyngiomas were diagnosed in 4 patients (2 adults and 2 children). Total tumor ablation was performed only in one case.
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PMID:[Expansive processes in the optic chiasm region]. 892 47

In children with craniopharyngioma, poor growth commonly precedes diagnosis, but is observed less frequently than neurological or visual symptoms. A deficiency of growth hormone (GH) is common before, and almost universal after, treatment of the tumour, and is usually treated with GH. However, a minority of these children with GH deficiency (GHD) grow well without GH replacement therapy but exhibit other metabolic effects of GHD that are correctable by GH treatment. This article provides a review of studies in 422 children with craniopharyngioma whose details have been entered into the database of KIGS, the Kabi International Growth Study. The response to GH during the first year of therapy was similar to that seen in children with idiopathic GHD (IGHD). Leg length was relatively greater than sitting height and this disproportion was maintained during treatment. Adiposity increased in some children receiving GH treatment. At the end of GH treatment in 82 patients, there was a median gain in height SD score of 1.51, with evidence of residual growth potential still remaining in the majority. Tumour recurrence occurred in 13.5% of the total group of patients with craniopharyngioma within KIGS, at a median of 3.9 years from diagnosis and 2.3 years from the start of GH therapy. Tumour recurrence was not associated with an impairment in height achieved, but there was a tendency towards greater adiposity in patients in whom recurrence occurred. Adverse events during GH treatment were more frequent in children with craniopharyngioma than in those with IGHD, and headache was commonly reported. The results of these studies suggest that GH treatment is recommended for the treatment of children with craniopharyngioma on the grounds of improved growth velocity, adult height and other GH-dependent metabolic functions, and of the good safety profile of GH in these patients.
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PMID:Effect of growth hormone treatment in children with craniopharyngioma with reference to the KIGS (Kabi International Growth Study) database. 905 21

Results of the treatment of 27 children with craniopharyngioma are reported. A subfrontal pterional approach was used in 55.6% of cases, a transsphenoidal and a transcallosal or transcortical approach in 25.9% and 18.5% of cases, respectively. Radical removal was the goal of surgery and was achieved in 70.8% of cases treated as primary surgery. The operative mortality was 3.7% and was due to hypothalamic failure. Most (81.4%) patients were followed up, for a mean of 7 years. Patients were evaluated according to a functional evaluation scale and outcome categories proposed by us. The scale takes account of tumor (recurrences and their eventual evolution); visual functions; endocrine functions (mainly hypothalamic), attainment of endocrine balance and drug regimen; headache; and psychosocial function. Recurrences were observed in 17.6% of patients treated with radical surgery and in 42.8% of those treated with limited surgery plus radiotherapy. A progressive amelioration of visual, endocrine and neuropsychosocial functions from the intervention to follow-up was observed in the majority of patients. Complete tumor excision was associated in 85% of cases with a low score on the functional scale, reflecting a high functional performance. Adequate substitution therapy maintained endocrine balance in 81% of patients. Since the intervention a progressive decrease in the number and dosages of medications has been observed. The majority of patients were again able to lead a normal social life. Small stature, obesity, headache, and emotional and sexual disturbances were frequent cause of long-term disability even despite adequate drug regimens. The functional evaluation scale we propose is a simple and effective tool that can be easily used during routine evaluation of patients with craniopharyngioma.
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PMID:Long-term results of treatment for craniopharyngioma in children. 929 76

Craniopharyngioma, often with cystic diliatation, is difficult to resect radically. Fifty patients with huge craniopharyngioma (diameter of tumor was over 5 cm) treated with intratumoral irradiation of radioactive isotopes (32P and 90Y) through CT-guided Leksell stereotactic system are reported. The patients were 2 to 69 years of age with the disease of 1- to 12-year duration. Of the 50 patients, 21 had recurrent tumor after craniotomy, 29 without surgery operation before. All tumors were confirmed pathologically. The major clinical symptoms were as follows: visual field defect, headache, vomiting, diabetes insipidus, hemiplegia and growth retardation in juvenile cases. There was no death or serious complications following the treatment procedure. Partial response (> 50% reduction of tumor size on CT scanning with improvement of symptoms and signs) rate of the treatment was 82.0% at one month and 62.0% at 2 to 7 years after treatment.
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PMID:[Stereotactic intratumoral irradiation of huge craniopharyngioma]. 938 64

We studied short- and long-term responses to growth hormone (GH) treatment and adverse medical events (AE) in 488 patients with craniopharyngioma who were entered into the Kabi International Growth Study (KIGS). First-year growth response and responsiveness (n = 394) were similar to those seen in children with idiopathic GH deficiency. The growth response over 5 years (n = 152) was unaffected by the recurrence of tumour and prior tumour management, but was greater in those receiving thyroxine. Mean height standard deviation scores (SDS) at the end of GH treatment (n = 129) was -0.7+/-1.2, and 79% achieved a height over -2 SD of target height, with evidence of further growth potential. Final height SDS correlated positively with height SDS at the start of treatment and with target height SDS, whereas gain in height SDS was inversely correlated with height SDS and bone age at the start of GH treatment. The rate of recurrence of tumour, 0.045/treatment year, was greater in those who had been treated with surgery alone compared to surgery and cranial irradiation. Other AE included headaches, fluid retention and convulsions occurring at rates of 0.025, 0.005 and 0.004/treatment year, respectively. We concluded that GH treatment is safe and effective in children with craniopharyngioma and provide data for counselling of parents about outcome during GH treatment.
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PMID:Efficacy and safety of growth hormone treatment in children with prior craniopharyngioma: an analysis of the Pharmacia and Upjohn International Growth Database (KIGS) from 1988 to 1996. 948 78

We report a case of Rathke's cleft cyst associated with cholesterin granuloma in an 8-year-old girl with apoplexy. She was admitted to our hospital in April 1996 because of repeated headache and deep ophthalmic pain, without any visual disturbance. Computed tomography (CT) of the pituitary demonstrated an intrasellar isodense mass extending to the suprasellar cistern. Magnetic resonance imaging (MRI) showed a high-intensity mass on both T1- and T2-weighted images. The preoperative diagnosis of this lesion was Rathke's cleft cyst associated with a craniopharyngioma and/or hemorrhage. Transsphenoidal microsurgery was performed, and a bloody coffee-like serous and mucinous-yellowish substance was evacuated. Curettage of the wall removed the yellowish hard mass and soft membranous tissue. Histological examination of this tumor revealed a Rathke's cleft cyst with cholesterin granuloma.
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PMID:A case of Rathke's cleft cyst with apoplexy. 972 87

A patient of craniopharyngioma associated with intratumoral bleeding was reported. A 44-year-old female was admitted to our department with sudden onset of headache suggesting pituitary apoplexy. On admission, she complained of mild bifrontalgia and neurological examination revealed no abnormality except bitemporal hemianopsia. Hormonal examination indicated hypopituitarism with masked diabetes insipidus and chronic thyroiditis. MRI showed a cystic 12 x 10 x 10 mm tumor with an enhanced rim at the intra- and suprasellar region. The MRI findings of the cyst suggested intratumoral bleeding with various stages. CT and plain tomography revealed plane calcification adjusting or aligning itself to the floor of the sellar. This calcification was difficult to distinguish from the sellar floor on MRI. Under the diagnosis of craniopharyngioma, almost all of the tumor was removed, using the transsphenoidal approach. The cyst consisted of old hematoma and cholesterin. The histological examination revealed a stratified squamous epithelia with numerous immature blood vessels. Such findings are unusual in cases of craniopharyngioma. Craniopharyngioma is rarely associated with intratumoral hemorrhage. The mechanism of this hemorrhage was discussed with reference to the literature on this subject.
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PMID:[A case of craniopharyngioma with intratumoral hemorrhage]. 1002 88

A 16 year female with a history of developmental delay and shunted hydrocephalus presented with two months of progressive headaches, lethargy and visual disturbances. An MRI of the brain revealed a sellar and suprasellar cystic mass which was absent on a previous MRI six years earlier. The pre-operative clinical diagnosis was pituitary adenoma vs. craniopharyngioma. Histologically, the fibrous wall of the ciliated epithelial-lined cyst was thickened by non-caseating granulomatous inflammation, hemorrhage, hemosiderin, and cholesterol clefts, consistent with cyst rupture. Rathke's cleft cysts are uncommon symptomatic lesions in young people, and must be distinguished from craniopharyngioma.
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PMID:December 1998--16 year old female with headaches, lethargy and a sellar/suprasellar mass. 1021 56

The clinical, radiographic findings in 12 patients with symptomatic Rathke cleft cysts (RCC) are presented. The mean age of these patients was 52 years, and 9 of the patients were female. Visual disturbance was the most common symptom, followed by headache. Magnetic resonance images (MRIs) were reviewed in 11 cases. In two cases, the cyst fluid had low signal intensity on T1-weighted images and high intensity on T2-weighted images. In eight cases the cyst fluid had iso-to-high intensity on both T1 and T2-weighted images. On dynamic MRI study using Gd-DTPA, normal anterior pituitary gland was seen superior to the RCC in 4 cases, anterior in 4, and inferior in 2 cases. In accordance with the MRI findings, transcranial approach was chosen in 4 cases and the transsphenoidal route was used in eight cases. Most symptoms and signs improved or resolved following surgery with the exception of those cases with a long-standing history of hypopituitarism. We experienced two cases of recurrence at 7 months, and 65 months respectively requiring a second operation, and the mean follow-up period for all cases was 78 months. Differential diagnosis between RCC and craniopharyngioma should be carefully made in the recurrent cases by surgical specimens of the cyst wall. Partial resection of the cyst wall and drainage of the contents via the transsphenoidal route is a safe and effective procedure in the majority of cases, but the transcranial approach is the treatment of choice in cases in which the cyst is entirely located in the suprasellar region.
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PMID:[Clinical study of symptomatic Rathke cleft cyst]. 1044 36


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