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Increased Intracranial Pressure ll: Pathophysiology

Increased Intracranial Pressure ll: Pathophysiology

Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...

Increased Intracranial Pressure l: Introduction

Increased Intracranial Pressure l: Introduction

Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...

Cushing Syndrome II: Pathophysiology

Cushing Syndrome II: Pathophysiology

Cortisol production is normally governed by the hypothalamic–pituitary–adrenal (HPA) axis, which maintains hormonal balance through tightly regulated feedback mechanisms. Disruption of this regulatory system is central to the development of Cushing syndrome, whether the excess cortisol originates from external medications or internal pathology. Persistent cortisol elevation alters metabolism, immune function, and endocrine signaling, producing the characteristic clinical features of the...

Cushing Syndrome I: Introduction

Cushing Syndrome I: Introduction

Cushing syndrome refers to the collection of clinical manifestations that arise when tissues are exposed to excessive amounts of cortisol or cortisol-like medications over an extended period. Cortisol, a glucocorticoid produced by the adrenal cortex, regulates metabolism, immune responses, and the body’s adaptation to stress. When its concentration remains chronically elevated, these physiological pathways become dysregulated, resulting in the characteristic features of the syndrome.Exogenous...

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Updated: Jun 4, 2026

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

Published on: January 17, 2018

Giant prolactinoma causing cranio-cervical junction instability: a case report.

Malik J A Zaben¹, Stuart E Harrisson, N V Mathad

¹Department of Neurosurgery, Wessex Neurological Centre, Southampton University Hospitals NHS Trust, Southampton SO16 6YD, UK.

British Journal of Neurosurgery

|February 25, 2011

Summary

Giant prolactinomas can aggressively invade surrounding structures, causing instability. This case highlights the need for surgical fixation in exceptionally destructive pituitary tumors.

Related Experiment Videos

Last Updated: Jun 4, 2026

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

Published on: January 17, 2018

Area of Science:

Neuroendocrinology
Neurosurgery
Oncology

Background:

Prolactinomas, common pituitary tumors, are typically managed with dopamine agonists.
Rarer giant prolactinomas can invade adjacent structures, posing significant clinical challenges.

Observation:

A case of an exceptionally aggressive giant prolactinoma is presented.
This tumor demonstrated extensive erosion of the occipital condyles.

Findings:

The occipital condyle erosion led to cranio-cervical joint instability.
This instability necessitated surgical intervention for stabilization.

Implications:

Highlights the potential for extreme bone destruction by giant prolactinomas.
Underscores the importance of considering surgical fixation for cranio-cervical instability caused by pituitary tumors.