Cases reported "Intracranial Hemorrhages"

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1/5. Spontaneous haemorrhage into an empty sella turcica mimicking pituitary apoplexy.

    We present a case of spontaneous haemorrhage into an empty sella turcica with the features of subclinical pituitary apoplexy. A 66-year-old woman with a previously resected pituitary adenoma presented four months later with progressive headache and visual deterioration. Cranial MRI demonstrated hyperacute blood products in a recurrent pituitary adenoma. Operative findings were of subacute blood in an empty sella turcica. There was no operative or subsequent histological evidence of tumour recurrence. The intrasellar haemorrhage was evacuated via a trans-sphenoidal approach, resulting in a rapid improvement in visual function. Endocrine deficits required thyroxine, corticosteroid and desmopressin supplementation. Haemorrhage into an empty sella turcica has not been previously described and needs to be suspected as a clinical entity in patients presenting with the features of pituitary apoplexy. awareness of this clinical condition will prevent preoperative misdiagnosis.
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ranking = 1
keywords = sella turcica, turcica, sella
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2/5. Resolution of Cushing's disease followed by secondary adrenal insufficiency after anticoagulant-associated pituitary hemorrhage: report of a case and review of the literature.

    OBJECTIVE: To describe the 12th well-documented case of spontaneous resolution of pituitary Cushing's disease due to pituitary hemorrhage and to review data on the previous 11 such patients described in the literature. methods: We present the longitudinal clinical, endocrinologic, and radiographic data in a 41-year-old woman with Cushing's disease before and after pituitary hemorrhage and summarize similar data in 11 previous reports of patients who convincingly appear to demonstrate the same syndrome. RESULTS: A 41-year-old woman with classic features of Cushing's disease had an overnight dexamethasone suppressed serum cortisol level of 23 mg/dL. Five months later, symptomatic pituitary hemorrhage developed in conjunction with characteristic pituitary magnetic resonance imaging findings and a serum cortisol value of 2.2 mg/dL. During the ensuing 8 months, she lost her Cushing's habitus, demonstrated improvement in her secondary adrenal insufficiency, and developed an empty right sella turcica, which remained unchanged on 1-year follow-up magnetic resonance imaging of the pituitary. An overnight metyrapone test 3 months later yielded normal results. CONCLUSION: Spontaneous remission in pituitary Cushing's disease, with or without later recurrence, has now been well documented in 12 patients. These findings (1) compel a reassessment of whether previously described patients experiencing spontaneous remission in association with medical therapy may have actually sustained asymptomatic pituitary hemorrhage and (2) raise the question of whether, in selected patents with microadenomas, medical treatment of Cushing's disease should be considered more often.
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ranking = 0.14239710424211
keywords = sella turcica, turcica, sella
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3/5. optic nerve glioma manifesting as intratumoral hemorrhage in a pregnant woman--case report.

    A 33-year-old pregnant woman presented with intratumoral hemorrhage in an astrocytoma of the left optic nerve and chiasm manifesting as poor vision in her left eye. Visual examination found no light perception in the left eye and deteriorated acuity with temporal hemianopsia in the right eye. Computed tomography demonstrated a round high-density mass in the suprasellar region. T2-weighted magnetic resonance (MR) imaging showed the center of the mass as mildly hypointense and T2-weighted MR imaging as hypointense. Both T1- and T2-weighted MR imaging showed the rim of the mass as hyperintense. She delivered a healthy baby by cesarean section. A left frontotemporal craniotomy was then performed. Incision of the lateral surface of the left optic nerve revealed clotted blood from the left optic nerve and the left side of the chiasm. No vascular malformation was noted in the hematoma cavity. Histological examination revealed a neoplasm composed of well-differentiated astrocytic cells. No Rosenthal fibers were identified. The patient made an uneventful postoperative recovery. Her right visual acuity returned to normal, but the temporal hemianopsia in the right eye and the blindness in the left eye persisted. Gliomas of the anterior visual pathways are rare, especially in adults. The hemorrhage may have been caused by the hypercoagulable state associated with pregnancy. Optic nerve astrocytic glioma with intratumoral hemorrhage should be considered in the differential diagnosis of suprasellar hematoma.
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ranking = 0.0064405406105237
keywords = sella
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4/5. Craniopharyngiomas with intratumoral hemorrhage--two case reports.

    Two cases of craniopharyngioma with intratumoral hemorrhage are reported. A 22-year-old male was admitted with meningitis. Lumbar tapping was performed twice. He subsequently developed reduced visual acuity and field deterioration due to intratumoral hemorrhage from an intra- and suprasellar tumor. He underwent emergency craniotomy and total extirpation of the tumor. A 29-year-old female underwent partial extirpation of an intra- and suprasellar cystic tumor via transsphenoidal surgery. Two months after the first operation, she suffered intratumoral hemorrhage necessitating emergency surgery and subsequent gamma-knife therapy. The histological diagnosis was craniopharyngioma in both cases. hemorrhage is extremely rare in craniopharyngiomas and difficult to discriminate from that in pituitary adenoma, but both diseases require decompression by clot extirpation.
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ranking = 0.0064405406105237
keywords = sella
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5/5. Empty sella, hypogonadism and hypopituitarism secondary to moyamoya disease.

    We report the case of a young male who presented at the age of 34 years with intracranial hemorrhage due to moyamoya disease. He was later diagnosed with hypogonadism and hypopituitarism. Chromosomal evaluation revealed a normal karyotype. The results of further neuroradiological studies led to the diagnosis of empty sella syndrome.
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ranking = 0.016101351526309
keywords = sella
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