Abstract:
OBJECTIVES:It is well-known that Rathke's cleft cysts (RCCs) infrequently cause headache, endocrinological dysfunction, and visual disturbance, and in rare cases, cause diabetes insipidus (DI). Although surgical evacuation of the cyst content can result in high rates of symptomatic improvement, not only the treatment efficacy but also the pathophysiology of DI with RCC are undetermined. The aim of this study is to elucidate the underlying mechanisms and outcomes of DI associated with RCCs. PATIENTS AND METHODS:We retrospectively studied 109 patients with RCCs treated at Kanazawa University Hospital between 2000 and 2016. Their age, sex, symptoms, endocrinological status, DI, visual disturbance, neuroradiological findings, pathological appearances, and pre-/post-operative hormone levels and status of anti-diuretic hormone replacements were assessed. RESULTS:Among 109 cases of RCCs, five cases (4.6%, 2 males and 3 females) manifested with DI as initial presentation were included. These five cases could be divided into two types: the acute type and the chronic type, based on the onset and duration of symptoms. Three acute onset cases presented with not only strong thirst but also sudden headaches without pituitary dysfunction, whereas the two chronic onset cases presented with chronic headaches and hypopituitarism. Pathological examination in the acute type revealed inflammatory cell infiltration into only the posterior lobe of the pituitary and disruption of the cyst wall adjacent to the posterior lobe, which might suggest RCC rupture. In contrast, the chronic type showed inflammatory cell infiltration into both the anterior and posterior lobes of the pituitary and thickened fibrosis beneath the cyst wall. Postoperatively, two cases of the acute type could be controlled with a smaller amount of 1-deamino-8-D-arginine vasopressin (DDAVP) than that required preoperatively, whereas no change was observed in the cases of the chronic type. CONCLUSION:The cases of DI onset caused by RCCs could be divided into the acute type and the chronic type. In the chronic type, surgical treatment could not affect the status of DI. However, in acute type, urgent surgical intervention partially relieved DI.
journal_name
Clin Neurol Neurosurgjournal_title
Clinical neurology and neurosurgeryauthors
Oishi M,Hayashi Y,Sasagawa Y,Kita D,Tachibana O,Nakada Mdoi
10.1016/j.clineuro.2018.02.031subject
Has Abstractpub_date
2018-04-01 00:00:00pages
141-146eissn
0303-8467issn
1872-6968pii
S0303-8467(18)30082-9journal_volume
167pub_type
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
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journal_title:Clinical neurology and neurosurgery
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更新日期:2015-08-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2005.08.007
更新日期:2006-09-01 00:00:00
abstract::A patient is presented who developed a frontal intracerebral hemorrhage, which proved to be due to a metastasis of a choriocarcinoma. The patient's uterus and adnexa had been removed two years previously for a non-malignant disorder. two years previously for a non-malignant disorder. The authors stress the importance ...
journal_title:Clinical neurology and neurosurgery
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更新日期:1985-01-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
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doi:10.1016/j.clineuro.2008.03.010
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2005.09.002
更新日期:2006-12-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1987-01-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
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journal_title:Clinical neurology and neurosurgery
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pub_type: 杂志文章
doi:10.1016/s0303-8467(97)00073-5
更新日期:1997-10-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2020.106449
更新日期:2020-12-28 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/s0303-8467(97)00070-x
更新日期:1997-10-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/0303-8467(96)00035-2
更新日期:1996-11-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/s0303-8467(88)80031-3
更新日期:1988-01-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2017.06.013
更新日期:2017-09-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/0303-8467(91)90007-c
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pub_type: 杂志文章
doi:10.1016/j.clineuro.2020.105719
更新日期:2020-05-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/s0303-8467(97)00026-7
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更新日期:2019-05-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2012.12.031
更新日期:2013-08-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/s0303-8467(75)80048-5
更新日期:1975-01-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/0303-8467(94)90027-2
更新日期:1994-02-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2020.106161
更新日期:2020-10-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2018.06.044
更新日期:2018-09-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2008.12.001
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:Acute encephalitis syndrome (AES) is a constellation of symptoms that includes fever and altered mental status. Most cases are attributed to viral encephalitis (VE), occurring either in outbreaks or sporadically. We conducted hospital-based surveillance for sporadic adult-AES in rural Central India in order ...
journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2013.04.008
更新日期:2013-09-01 00:00:00
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journal_title:Clinical neurology and neurosurgery
pub_type: 杂志文章
doi:10.1016/j.clineuro.2019.105572
更新日期:2020-02-01 00:00:00