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[Recurrent cystic "hypophyseal abscess"].

H Schenke1, R Besel, J Schneider

  • 1Abteilung für Neurochirurgie, Medizinischen Akademie Erfurt.

Zentralblatt Fur Neurochirurgie
|January 1, 1987
PubMed
Summary

A rare primary hypophyseal abscess caused acute chiasmal syndrome. A transethmoideo-sphenoid approach successfully drained the abscess, suggesting Rathke

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Area of Science:

  • Neurosurgery
  • Endocrinology
  • Ophthalmology

Background:

  • Primary hypophyseal abscesses are exceedingly rare, particularly presenting with acute chiasmal syndrome.
  • This case represents a unique occurrence within a series of 426 hypophyseal interventions.

Observation:

  • The patient presented with acute chiasmal syndrome secondary to a primary hypophyseal abscess.
  • Initial surgical attempts using pterional exposures resulted in relapse.

Findings:

  • A third surgical intervention utilizing a transethmoideo-sphenoid access was performed.
  • This approach facilitated direct drainage of the abscess into the paranasal sinuses.
  • Histological examination suggested a Rathke's cyst as the potential origin of the abscess.

Implications:

  • The transethmoideo-sphenoid approach is identified as a viable and effective method for managing hypophyseal abscesses.
  • Understanding the genesis, potentially from Rathke's cysts, aids in differential diagnosis and treatment planning.
  • This case highlights the importance of considering less common pathologies in pituitary region interventions.

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