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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
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Pituitary hyperplasia causing complete bitemporal hemianopia with resolution following surgical decompression: case
Nataly Raviv1, Ami Amin2, Tyler J Kenning1
11Departments of Neurosurgery.
Journal of Neurosurgery
|August 16, 2020
Summary
Idiopathic pituitary hyperplasia, even with mild optic chiasm contact, can cause vision loss and amenorrhea. Surgical decompression effectively resolves these symptoms, restoring normal function.
Area of Science:
- Endocrinology
- Neurosurgery
- Ophthalmology
Background:
- Idiopathic pituitary hyperplasia (PH) is an enlarged pituitary gland of unknown cause.
- PH can present with various symptoms due to mass effect, even with normal pituitary function.
- While often incidental, PH can cause significant neurological and hormonal disturbances.
Observation:
- A 24-year-old woman presented with bitemporal hemianopia and amenorrhea.
- Imaging showed an enlarged pituitary gland mildly contacting the optic chiasm, with normal pituitary hormone levels.
- The patient underwent endoscopic endonasal transsphenoidal surgery for decompression.
Findings:
- Pathology confirmed pituitary hyperplasia.
- Post-surgery, the patient experienced complete resolution of bitemporal hemianopia.
- Menstruation resumed within 3 days, and hormonal deficits were absent.
Implications:
- Surgical decompression is an effective treatment for symptomatic pituitary hyperplasia.
- This case highlights that PH can cause severe visual and reproductive symptoms despite minimal compression and normal function.
- Early surgical intervention can lead to complete symptom resolution and prevent long-term deficits.
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