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Neill E. F. Cartlidge and David A. Shaw

T he association of hypopituitarism with intracranial aneurysm is well recognized. Bramwell 2 in 1887 described two patients with clinical features that in retrospect were suggestive of pituitary deficiency and who at autopsy were found to have large aneurysms of the internal carotid artery. Subsequent reports of aneurysms simulating pituitary tumors were fully reviewed by White and Ballantine 8 in 1961. Their series numbered 35 in all, and two later reviews by Van't Hoff, et al., 6 and Kahana, et al., 5 included five similar cases. A single case report

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Ji Woong Oh, Kyoung Su Sung, Ju Hyung Moon, Eui Hyun Kim, Won Seok Chang, Hyun Ho Jung, Jin Woo Chang, Yong Gou Park, Sun Ho Kim and Jong Hee Chang

N onfunctioning pituitary adenomas (NFPAs) make up about 15%–30% of all pituitary adenomas. 2 , 4 Even if a complete tumor resection is performed by an experienced surgeon, the recurrence rate is 20%–40% with diverse clinical symptoms. 9 , 15 Hence, additional Gamma Knife surgery (GKS) is widely performed not only after subtotal removal, but also after total tumor resection if there is evidence of tumor recurrence. The radiosurgical procedure is a less invasive treatment; however, there is a risk of hypopituitarism following treatment. Not much has been

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J. I. Lara Capellan, L. Cuellar Olmedo, J. Martinez Martin, Ma del Mar Marin, M. Garcia Villanueva, F. Marin Zarza and H. De La Calle Blasco

S arcoidosis uncommonly affects the central nervous system (CNS), this involvement being recorded in only 3.5% to 5% of cases; in addition, hypopituitarism presenting as the only clinical manifestation of sarcoidosis is extremely unusual. 16, 26 Hypopituitarism is rarely reported without diabetes insipidus. 21 In this paper, we describe a case of CNS sarcoidosis showing hypopituitarism without diabetes insipidus. Case Report This 45-year-old woman was referred with a 2-year history of headache, loss of weight, asthenia, pedal edema, intolerance to low

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Jae Hyun Jeong, Young Zoon Kim, Yong Woon Cho and Joon Soo Kim

trauma, and the first such case was reported by Cyran in 1918. 8 Two recent literature reviews have provided additional data on hypopituitarism following head trauma. In their review, Benvenga et al. 5 concluded that road accidents were responsible for approximately 75% of all cases of hypopituitarism due to brain injury. However, no comprehensive study has been conducted on hypopituitarism following DAI, or on the functional outcomes of hypopituitarism following DAI. In 1998, our hospital was authorized to establish an official wide regional emergency center in

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Diogo Cordeiro, Zhiyuan Xu, Gautam U. Mehta, Dale Ding, Mary Lee Vance, Hideyuki Kano, Nathaniel Sisterson, Huai-che Yang, Douglas Kondziolka, L. Dade Lunsford, David Mathieu, Gene H. Barnett, Veronica Chiang, John Lee, Penny Sneed, Yan-Hua Su, Cheng-chia Lee, Michal Krsek, Roman Liscak, Ahmed M. Nabeel, Amr El-Shehaby, Khaled Abdel Karim, Wael A. Reda, Nuria Martinez-Moreno, Roberto Martinez-Alvarez, Kevin Blas, Inga Grills, Kuei C. Lee, Mikulas Kosak, Christopher P. Cifarelli, Gennadiy A. Katsevman and Jason P. Sheehan

as 10%–50% of pituitary adenomas. 6 In FPA patients, such recurrence/progression can lead to a persistent hypersecretory state and related systemic morbidity. Historically, fractionated radiation therapy (RT) was used to treat patients with recurrent or progressive adenomas. However, over the past 2–3 decades, stereotactic radiosurgery (SRS), predominantly with the Gamma Knife, has been increasingly employed in the management of such patients. 2 , 14 , 19 , 28 , 39 Following SRS, delayed onset of hypopituitarism (any axis) occurs in 20%–100% of patients. 5 , 21

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Ping Zheng, Bin He, Yijun Guo, Jingsong Zeng and Wusong Tong

cognitive function, memory disturbance, decreased activity, failure of emotional control, carelessness, excessive tenacity, and planning failure, 18 which often cause social problems in families, schools, work places, and communities. Hypopituitarism has been found to occur in 21% –54% of TBI patients, 8 and it may contribute to lasting cognitive and behavioral symptoms in this population. 7 However, direct anatomical evidence of hypopituitarism after TBI is extremely difficult to detect with conventional imaging techniques. 3 , 12 , 15 Recent technical developments

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Daniel F. Kelly, Irene T. Gaw Gonzalo, Pejman Cohan, Nancy Berman, Ronald Swerdloff and Christina Wang

Despite these studies and numerous case reports of patients with posttraumatic hypopituitarism, 8, 24, 25, 29, 33, 44, 48, 49, 52 prospective cohort studies of trauma-induced pituitary failure have never been performed. Reports on pituitary dysfunction after aneurysmal SAH are even more limited and have only contained descriptions of the direct mechanical effects of an aneurysm compressing the pituitary gland; 27 the effects of the SAH per se on pituitary function have never been studied. Consequently, the rate, risk factors, and clinical significance of

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Robert M. Starke, Brian J. Williams, John A. Jane Jr. and Jason P. Sheehan

event of tumor progression or residual tumor, conventional radiotherapy offers tumor control rates of 90% or higher, but with significant risks of hypopituitarism, radiation-induced tumors, carotid stenosis and stroke, as well as neurocognitive side effects. 2 , 16 , 25 , 26 Stereotactic fractionated radiotherapy helps reduce some of these risks and may be used as primary treatment in a select number of patients. 27 Stereotactic radiosurgery can be used to treat patients with recurrent nonfunctioning adenomas and may be used as a primary treatment in a group of

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Thaira Oweity, Bernd W. Scheithauer, Hin San Ching, Chang Moh C. Lei and Koh Ping Wong

biopsies have seldom been documented and none in the setting of a hypothalamic tumor and hypopituitarism. In this paper we report the case of a 55-year-old man with a 7-year history of DI, in whom panhypopituitarism and hyperprolactinemia developed as well as progressive retroperitoneal and bone disease. The diagnosis of ECD was made on biopsy of a hypothalamic mass. A retrospective review of bone radiographs and neuroimages confirmed the diagnosis. Case Report History This 55-year-old retired Chinese businessman presented in June 1999 with the complaint of

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Julie Dubourg and Mahmoud Messerer

I n today's realm of competitive sports environments worldwide, a large number of athletes participate in a wide variety of amateur or professional sports. Closed head injury is an occupational hazard of many sports, such as boxing, kickboxing, ice hockey, football, and many others. Participants in these sports are at risk for concussion, which is considered a type of mild TBI. During the past decade, numerous studies have shown that TBI is often responsible for pituitary dysfunction such as hypopituitarism, 2 , 29 , 55 which seems to be readily present