Reversible dementia due to macroprolactinoma

Case report

Restricted access

✓ Subfrontal tumors are an infrequent cause of dementia. Most of those that do cause dementia are meningiomas, and the symptoms may recede when the tumor is resected. A patient with a huge prolactinoma who came to medical attention because of dementia is described. The tumor shrank dramatically after bromocriptine therapy and the patient's mental status returned to normal.

Article Information

Address reprint requests to: Michael R. Fetell, M.D., The Neurological Institute, 710 West 168th Street, New York, New York 10032.

© AANS, except where prohibited by US copyright law.

Headings

Figures

  • View in gallery

    Coronal magnetic resonance imaging sections without gadolinium enhancement, obtained at presentation on April 10, 1989, illustrating a large skull-base tumor.

  • View in gallery

    Coronal magnetic resonance imaging sections with gadolinium enhancement, obtained on April 26, 1990, after 1 year of bromocriptine treatment, illustrating marked reduction in tumor size.

References

  • 1.

    Barrow DLMizuno JTindall GT: Management of prolactinomas associated with very high serum prolactin levels. J Neurosurg 68:5545581988Barrow DL Mizuno J Tindall GT: Management of prolactinomas associated with very high serum prolactin levels. J Neurosurg 68:554–558 1988

    • Search Google Scholar
    • Export Citation
  • 2.

    Chiodini PLiuzzi ACozzi Ret al: Size reduction of macroprolactinomas by bromocriptine or lisuride treatment. J Clin Endocrinol Metab 53:7377431981Chiodini P Liuzzi A Cozzi R et al: Size reduction of macroprolactinomas by bromocriptine or lisuride treatment. J Clin Endocrinol Metab 53:737–743 1981

    • Search Google Scholar
    • Export Citation
  • 3.

    Cummings JBenson DFLoVerme S Jr: Reversible dementia. Illustrative cases, definition, and review. JAMA 243:243424391980Cummings J Benson DF LoVerme S Jr: Reversible dementia. Illustrative cases definition and review. JAMA 243:2434–2439 1980

    • Search Google Scholar
    • Export Citation
  • 4.

    Grote E: Characteristics of giant pituitary adenomas. Acta Neurochir 60:1411531982Grote E: Characteristics of giant pituitary adenomas. Acta Neurochir 60:141–153 1982

    • Search Google Scholar
    • Export Citation
  • 5.

    Larson EBReifler BVFeatherstone HJet al: Dementia in elderly outpatients: a prospective study. Ann Intern Med 100:4174231984Larson EB Reifler BV Featherstone HJ et al: Dementia in elderly outpatients: a prospective study. Ann Intern Med 100:417–423 1984

    • Search Google Scholar
    • Export Citation
  • 6.

    McGregor AMScanlon MFHall Ret al: Effects of bromocriptine on pituitary tumour size. Br Med J 2:7007031979McGregor AM Scanlon MF Hall R et al: Effects of bromocriptine on pituitary tumour size. Br Med J 2:700–703 1979

    • Search Google Scholar
    • Export Citation
  • 7.

    Murphy FYVesely DLJordan RMet al: Giant invasive prolactinomas. Am J Med 83:99510021987Murphy FY Vesely DL Jordan RM et al: Giant invasive prolactinomas. Am J Med 83:995–1002 1987

    • Search Google Scholar
    • Export Citation
  • 8.

    Nabarro JDN: Pituitary prolactinomas. Clin Endocrinol 17:1291551982Nabarro JDN: Pituitary prolactinomas. Clin Endocrinol 17:129–155 1982

    • Search Google Scholar
    • Export Citation
  • 9.

    Pellegrini IRasolonjanahary RGunz Get al: Resistance to bromocriptine in prolactinomas. J Clin Endocrinol Metab 69:5005091988Pellegrini I Rasolonjanahary R Gunz G et al: Resistance to bromocriptine in prolactinomas. J Clin Endocrinol Metab 69:500–509 1988

    • Search Google Scholar
    • Export Citation
  • 10.

    Pia HWGrote EHildebrandt G: Giant pituitary adenomas. Neurosurg Rev 8:2072201985Pia HW Grote E Hildebrandt G: Giant pituitary adenomas. Neurosurg Rev 8:207–220 1985

    • Search Google Scholar
    • Export Citation
  • 11.

    Post KDMcCormick PCBello JA: Differential diagnosis of pituitary tumors. Endocrinol Metab Clin 16:6096451987Post KD McCormick PC Bello JA: Differential diagnosis of pituitary tumors. Endocrinol Metab Clin 16:609–645 1987

    • Search Google Scholar
    • Export Citation
  • 12.

    Srivastava VKNarayanaswamy KSRao TV: Giant pituitary adenoma. Surg Neurol 20:3793821983Srivastava VK Narayanaswamy KS Rao TV: Giant pituitary adenoma. Surg Neurol 20:379–382 1983

    • Search Google Scholar
    • Export Citation
  • 13.

    Thorner MOMartin WHRogol ADet al: Rapid regression of pituitary prolactinomas during bromocriptine treatment. J Clin Endocrinol Metab 51:4384451980Thorner MO Martin WH Rogol AD et al: Rapid regression of pituitary prolactinomas during bromocriptine treatment. J Clin Endocrinol Metab 51:438–445 1980

    • Search Google Scholar
    • Export Citation
  • 14.

    Thorner MOPerryman RLRogol ADet al: Rapid changes of prolactinoma volume after withdrawal and reinstitution of bromocriptine. J Clin Endocrinol Metab 53:4804831981Thorner MO Perryman RL Rogol AD et al: Rapid changes of prolactinoma volume after withdrawal and reinstitution of bromocriptine. J Clin Endocrinol Metab 53:480–483 1981

    • Search Google Scholar
    • Export Citation
  • 15.

    Van't Verlaat JWCroughs RJMHendriks MJet al: Results of primary treatment with bromocriptine of prolactinomas with extrasellar extension. Can J Neurol Sci 17:71731990Van't Verlaat JW Croughs RJM Hendriks MJ et al: Results of primary treatment with bromocriptine of prolactinomas with extrasellar extension. Can J Neurol Sci 17:71–73 1990

    • Search Google Scholar
    • Export Citation
  • 16.

    Warfield AFinkel DMSchatz NJet al: Bromocriptine treatment of prolactin-secreting pituitary adenomas may restore pituitary function. Ann Intern Med 101:7837851984Warfield A Finkel DM Schatz NJ et al: Bromocriptine treatment of prolactin-secreting pituitary adenomas may restore pituitary function. Ann Intern Med 101:783–785 1984

    • Search Google Scholar
    • Export Citation
  • 17.

    Wass JAHWilliams JCharlesworth Met al: Bromocriptine in management of large pituitary tumors. Br Med J 284:190819111982Wass JAH Williams J Charlesworth M et al: Bromocriptine in management of large pituitary tumors. Br Med J 284:1908–1911 1982

    • Search Google Scholar
    • Export Citation
  • 18.

    Zárate ACanales ESCano Cet al: Follow-up of patients with prolactinomas after discontinuation of long-term therapy with bromocriptine. Acta Endocrinol 104:1391421983Zárate A Canales ES Cano C et al: Follow-up of patients with prolactinomas after discontinuation of long-term therapy with bromocriptine. Acta Endocrinol 104:139–142 1983

    • Search Google Scholar
    • Export Citation
  • 19.

    Zimmerman EA: Tumors of the pituitary gland in Rowland LP (ed): Merritt's Textbook of Neurologyed 8. Philadelphia: Lea & Febiger1989 pp 318326Zimmerman EA: Tumors of the pituitary gland in Rowland LP (ed): Merritt's Textbook of Neurology ed 8. Philadelphia: Lea & Febiger 1989 pp 318–326

    • Search Google Scholar
    • Export Citation

TrendMD

Metrics

Metrics

All Time Past Year Past 30 Days
Abstract Views 70 70 10
Full Text Views 162 162 0
PDF Downloads 61 61 0
EPUB Downloads 0 0 0

PubMed

Google Scholar