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Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pituitary adenoma apoplexy is a well-known clinical syndrome induced by insulin infusion, cardiac surgery, trauma, and hypothalamic releasing factors. Pituitary apoplexy can cause secondary cerebral infarct and internal carotid artery occlusion. With blockade of tumor perfusion, apoplexy triggers a sudden onset of headache, visual impairment, cranial nerve palsy, disturbances of consciousness, eyelid ptosis, and hemiparesis. However, pituitary adenoma cells with high metabolic demand cannot survive with deficient blood supply and glucose concentrations. Moreover, a number of case reports have shown that spontaneous remission of syndromes, such as acromegaly, may be caused by pituitary adenoma after apoplexy. Therefore, understanding mechanism that underlies the balance between pituitary adenoma apoplexy and subsequent spontaneous remission of syndromes may suggest new approaches for treatment of pituitary adenoma apoplexy.
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PMID:Complex effects of apoplexy secondary to pituitary adenoma. 2780 76

Pituitary apoplexy is a potentially life-threatening clinical condition caused by rapid enlargement of a pituitary adenoma because of haemorrhage or infarction. The clinical features are typically acute in onset. We report an interesting case of 25-year-old man with complaints of sudden onset of headache and ophthalmoplegia in the right eye one month previously. He had ptosis and complete ophthalmoplegia in the right eye with visual acuity 6/24 and 6/12. Imaging showed a peripheral rim-enhancing mass lesion in the right parasellar and cavernous sinus with a dural tail. He underwent craniotomy and subtotal excision of the lesion. Histopathology was reported as pituitary apoplexy. Hormonal analysis was within normal limits. At two years of follow-up he had complete resolution of ophthalmoplegia and improvement in his vision. It is very uncommon to see pituitary apoplexy evolved in right parasellar region presenting as peripheral rim-enhancing mass lesion.
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PMID:Pituitary apoplexy presenting as a peripheral rim enhancing parasellar mass lesion with dural enhancement along the tentorium. 2858 57

A 71-year-old man had sustained intermittent ptosis and double vision for 2 weeks. Neurological examination found unilateral oculomotor nerve (CN III) paresis manifesting as limitations of gaze, ptosis, and mydriasis. Neither headache nor any other cranial neuropathy was noted. Cerebral magnetic resonance imaging revealed a well-circumscribed mass in the pituitary fossa extending laterally into the left cavernous sinus. The segment of the left CN III lying in the oculomotor cistern was considerably compressed by the tumor. The cisternal segments of the left CN III showed an undescribed, "hollow" appearance. The left orbit and brainstem were intact. The patient underwent tumor resection via an endoscopic transsphenoidal approach. The tumor tissue was soft in consistency, involving xanthochromic fluid. The pathological diagnosis was pituitary adenoma accompanied with considerable hemorrhagic changes. The patent's ptosis and limitations of gaze showed remarkable improvements on postoperative day 1, with resolution of the hollow appearance of the affected CN III that was confirmed on day 3. We assumed that the intralesional bleeds and lateral tumor extension into the oculomotor cistern were associated with the intermittent paresis of the CN III as the sole presentation. A hollow appearance identified in the CN III might indicate a reversible dysfunction of the nerve that can anticipate an improvement by prompt surgical intervention.
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PMID:Intermittent oculomotor nerve paresis and hollow appearance on MRI manifested by pituitary adenoma. 3152 42

We report a case of isolated unilateral complete pupil involving third cranial nerve palsy due to pituitary adenoma with parasellar extension into the right cavernous sinus. The patient was referred to us from neurosurgery with sudden onset binocular vertical diplopia with complete ptosis, and mild right-sided headache of 5-day duration. Ocular examination revealed pupil involving third cranial nerve palsy in right eye while rest of the examination including automated perimetry was normal. MRI brain with contrast revealed a mass lesion with heterogenous enhancement in the sella suggestive of a pituitary macroadenoma with possible internal haemorrhage (apoplexy). In addition, the MRI showed lateral spread to the right cavernous sinus which was causing compression of the right third cranial nerve. The patient was systemically stable. This report highlights a unique case as the lesion showed a lateral spread of pituitary adenoma without compression of the optic chiasm or other cranial nerves.
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PMID:Pituitary adenoma presenting as acute onset isolated complete third cranial nerve palsy without vision changes. 3258 14


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