Giant pituitary adenomas--an enigma revisited. Microsurgical treatment strategies and outcome in a series of 250 patients.

Abstract:

BACKGROUND:Giant pituitary adenomas (> 4 cm) are a surgical challenge. We present our experiences in surgical management of these tumors in a series of 250 patients. METHODS:Two hundred and fifty patients with giant pituitary adenomas were managed surgically at our center over last 13 years. Majority (92%) of patients presented with visual deterioration. Non-functioning tumors were found in 136 patients (54.3%). Among functioning adenomas, 63 patients (25.4%) had prolactinomas and 45 patients (18%) had GH-secreting adenomas; while 3 patients each had LH and ACTH- secreting adenomas. The maximum tumor diameter varied from 4 to 10.5 cm, with mean diameter of 5.4 cm. The factors determining choice of operative approach and surgical outcomes in these tumors were analyzed. RESULTS:Overall, 273 surgical procedures were performed in 250 patients. Of these, 110 were transsphenoidal, while 163 were transcranial approaches. A single surgical procedure was performed in 227 patients (89.2%). 23 patients (9.2%) underwent re-exploration either because of postoperative apoplexy or residual tumor. Overall, near total (>90%) tumor excision could be achieved in 74%, with improved vision in 53% and good outcome in 75% patients. The mortality and morbidity were 4.4% and 14%, respectively. CONCLUSIONS:The main goal of surgical treatment of giant pituitary adenoma is maximum possible tumor extirpation with minimal side effects, which can be achieved by careful preoperative planning of operative approach, based on directions of tumor extensions and invasiveness. Maximal surgical removal of giant adenomas offers best chances to control tumor growth when followed with adjuvant medical and radiation therapies.

journal_name

Br J Neurosurg

authors

Sinha S,Sharma BS

doi

10.3109/02688690903370305

subject

Has Abstract

pub_date

2010-02-01 00:00:00

pages

31-9

issue

1

eissn

0268-8697

issn

1360-046X

journal_volume

24

pub_type

杂志文章
  • The top 50 most-cited articles on low-grade glioma: a bibliometric analysis.

    abstract:PURPOSE:There is an abundance of articles published on low-grade glioma. The aim of this study was to identify and review the 50 most-cited articles on low-grade glioma, and to perform a bibliometric analysis. METHODS:In June 2017, we performed a basic search of the Web of Science database using "low-grade glioma mana...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688697.2018.1549314

    authors: Burak Atci I,Yilmaz H,Samanci MY

    更新日期:2019-04-01 00:00:00

  • Operative treatment of paediatric penetrating head injuries in southern Afghanistan.

    abstract::The operative management and early post-operative outcome of 16 consecutive cases of paediatric penetrating head injury treated by a single surgeon at a military trauma centre in Southern Afghanistan are retrospectively analysed. The majority of cases of injury were caused by fragments from exploding munitions. The ai...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688697.2013.767314

    authors: Mathew P,Gibbons AJ,Christie M,Eisenburg MF

    更新日期:2013-08-01 00:00:00

  • Publication fate of abstracts presented at Society of British Neurological Surgeons meetings.

    abstract:INTRODUCTION:Society of British Neurological Surgeons (SBNS) meetings are important national events which allow for the presentation of current academic work. The publication rate of presented abstracts is considered a proxy marker of the scientific strength of a conference. We aimed to determine the publication fate o...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688697.2014.915008

    authors: Jamjoom AA,Hughes MA,Chuen CK,Hammersley RL,Fouyas IP

    更新日期:2015-04-01 00:00:00

  • Bedside monitoring of CBF with xenon-CT and a mobile scanner: a novel method in neurointensive care.

    abstract::Combining previously independently established techniques our objective was to develop and evaluate a method for bedside qualitative assessment of cerebral blood flow in neurointensive care (NICU) patients. The CT-protocol was optimized using phantoms and comparing a mobile CT-scanner (Tomoscan-M, Philips) with two st...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688690500389898

    authors: Hillman J,Sturnegk P,Yonas H,Heron J,Sandborg M,Gunnarsson T,Mellergård P

    更新日期:2005-10-01 00:00:00

  • Unruptured intracranial aneurysms: an assessment of the annual risk of rupture based on epidemiological and clinical data.

    abstract::From autopsy and neuroradiological studies a maximum prevalence of unruptured intracranial aneurysms (UA) of 0.5% in the general population is revealed. Studies concerning the incidence of aneurysmal subarachnoid haemorrhage (SAH) revealed 10 cases per 100,000 inhabitants per year. From these epidemiological parameter...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章,评审

    doi:10.3109/02688698809001008

    authors: Rosenørn J,Eskesen V,Schmidt K

    更新日期:1988-01-01 00:00:00

  • Lymphoma of the trigeminal nerve--the need for histological diagnosis.

    abstract::CNS lymphoma involving the trigeminal nerve is a rare condition which presents as a cavernous sinus lesion. It may mimic the radiological appearance of other lesions, and biopsy is essential before considering empirical radiotherapy for lesions in this region. We report the radiological, histopathological and operativ...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688697.2013.835374

    authors: Perera C,Fitt G,Kalnins R,Lee S,Gonzalvo A

    更新日期:2014-04-01 00:00:00

  • Acute massive cerebellar infarction associated with craniocervical junction complex malformation: a case report and literature review.

    abstract::We report a case of acute massive cerebellar infarction associated with craniocervical junction (CVJ) complex malformation in a 21-year-old male. Timely surgical intervention prevented the deterioration of his neurological status. ...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688697.2016.1267329

    authors: Wang WT,Liu JJ,Duan K,Bie X,Liu TJ,Hao DJ

    更新日期:2018-10-01 00:00:00

  • Rathke's cleft cysts within a growth hormone producing pituitary adenoma.

    abstract::Two cases with a unique association of Rathke's cleft cysts and a growth hormone-secreting pituitary adenoma in the same tumour tissue are reported. The embryological pathogenesis, diagnostic evaluation and treatment of these lesions are discussed. ...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688699550041755

    authors: Nishio S Fujiwara T Morioka M Fukui S

    更新日期:1995-01-01 00:00:00

  • Optimal target localisation and eight-year outcome for subthalamic stimulation in patients with Parkinson's disease.

    abstract::Objective: Deep brain stimulation of the subthalamic nucleus (STN-DBS) is a useful therapy to improve motor functions and reduce dependence on medication in patients with Parkinson's disease (PD). The purpose of the study is to assess the long-term clinical outcomes of STN-DBS and to determine the optimal placement of...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688697.2020.1775786

    authors: Guo S,Li J,Zhang Y,Li Y,Zhuang P

    更新日期:2020-06-12 00:00:00

  • Intraventricular haematoma: management of comatose patients with valve regulated external ventricular drainage.

    abstract::Over a 2-year period, 22 consecutive comatose patients (Glasgow Coma Score of less than or equal to 8) with intraventricular haematomas were managed with prolonged external ventricular drainage via an external one-way valve regulated system. The mean duration of drainage was 12 days. The overall mortality was 23%. Acc...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688698809029600

    authors: Chan KH,Mann KS

    更新日期:1988-01-01 00:00:00

  • Posterior approach vertebrectomy in the thoracolumbar spine with expandable cage reconstruction: indications and techniques based on eight cases.

    abstract::We present a series of eight patients undergoing circumferential neural decompression and stabilization of the thoracolumbar spine via a single midline posterior approach, with complete vertebrectomy for a variety of indications. Four had primary tumours, two secondary tumours, one patient had tuberculosis and one had...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688690701837273

    authors: Crocker M,James G,Ibrahim A,Thomas N,Chitnavis B

    更新日期:2008-04-01 00:00:00

  • Fibrous dysplasia of the cervical spine presenting as a pathological fracture.

    abstract::Fibrous dysplasia (FD) is an uncommon benign fibro-osseous abnormality of bone, of unknown aetiology and equal sex incidence, which is most commonly restricted to one bone (monostotic FD: MFD, 70%). Less commonly multiple bones are affected (polyostotic FD: PFD, 27%). Vertebral involvement is uncommon (4%), but more c...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1080/02688690400012525

    authors: Marshman LA,David KM,O'Donovan DG,Chawda SJ

    更新日期:2004-10-01 00:00:00

  • Photodynamic therapy of malignant brain tumours: a phase I/II trial.

    abstract::Twenty patients bearing malignant brain tumours (18 glioblastoma multiforme, one malignant meningioma, one melanoma metastasis) were treated 25 times with photodynamic therapy (PDT)--the combination of Hematoporophyrin derivative and light at 630 nm (40-120 J/cm2). Sixteen times the PDT was followed immediately by a s...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688698808992675

    authors: Kostron H,Fritsch E,Grunert V

    更新日期:1988-01-01 00:00:00

  • Debate--does a reversible penumbra exist in intracerebral haemorrhage?

    abstract::Intracerebral haemorrhage is a devastating condition lacking effective therapies, with an uncertain role for surgery in many. Early research described an ischaemic penumbra around the haematoma, representing an area of potential therapeutic intervention. This article discusses the evidence for and against the existenc...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688697.2011.578773

    authors: Kirkman MA

    更新日期:2011-08-01 00:00:00

  • Establishing mild, moderate and severe criteria for the myelopathy disability index in cervical spondylotic myelopathy.

    abstract:AIM:Cervical Spondylotic Myelopathy (CSM) is a disabling condition arising from arthritic compression and consequent injury of the cervical spinal cord. Stratification of CSM severity has been useful to inform clinical practice and research analysis. In the UK the Myelopathy Disability Index (MDI) is a popular assessme...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688697.2020.1839741

    authors: Davies BM,Nourallah B,Venkatesh A,Ali AMS,Guilfoyle M,Francis J,Kotter MRN,Laing RJC

    更新日期:2020-11-10 00:00:00

  • Management of difficult intracranial aneurysms by deep hypothermia and elective cardiac arrest using cardiopulmonary bypass.

    abstract::Giant anterior circulation aneurysms and some basilar aneurysms can cause problems due to their size, the presence of clot in the aneurysm and the difficulty of applying a clip without kinking the perforating vessels. By utilising cardiopulmonary bypass via the femoro-femoral perforating vessels. By utilising cardiopu...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688698709035310

    authors: Richards PG,Marath A,Edwards JM,Lincoln C

    更新日期:1987-01-01 00:00:00

  • Primary optic nerve sheath schwannoma: a case report.

    abstract:BACKGROUND:The optic nerve is an unusual site of schwannoma as it lacks Schwannoma cells on it. We report a primary optic sheath schwannoma and to review the literature. CASE REPORT:A 29-year old female presented with progressive painless non-pulsatile proptosis. Ocular examination revealed only axial proptosis. Imagi...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688697.2020.1869181

    authors: Sharma A,Singh D,Saran R

    更新日期:2021-01-08 00:00:00

  • Epidermoid cyst of the cavernous sinus: clinical features, pathogenesis and treatment.

    abstract::Epidermoid cyst may rarely arise within the lateral wall of the cavernous sinus (CS) and produce clinical symptoms mimicking the Tolosa-Hunt syndrome. Pathogenically, it is suggested that some of the subpopulation of cells arising from the neural crest which give rise to skin, may remain entrapped in the meninges arou...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1080/02688690050206747

    authors: Tatagiba M,Iaconetta G,Samii M

    更新日期:2000-12-01 00:00:00

  • The influence of choice of therapy on quality of life in patients with neurogenic thoracic outlet syndrome.

    abstract:OBJECTIVES:We aimed to compare quality of life (QoL) after surgical decompression of the thoracic outlet versus non-operative therapy in patients with neurogenic thoracic outlet syndrome (N-TOS). DESIGN AND METHODS:We retrospectively identified 46 patients, diagnosed with N-TOS between 1999 and 2008. Twenty-four opera...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688697.2010.489656

    authors: Bosma J,Van Engeland MI,Leijdekkers VJ,Vahl AC,Wisselink W

    更新日期:2010-10-01 00:00:00

  • Surgical treatment of syringomyelia with syringopleural shunting.

    abstract::The clinical course of 21 patients who underwent syringopleural shunting for syringomyelia is summarised. All the patients were continuing to deteriorate at the time of the operation. Objective improvement was seen in nine patients following the procedure but three subsequently deteriorated. Contralateral syrinx sympt...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688698709034342

    authors: Williams B,Page N

    更新日期:1987-01-01 00:00:00

  • A CD99+ primary spinal central PNET in a pregnant patient- therapeutic concerns and issues.

    abstract::Spinal tumours in pregnancy are rare. Spinal tumours account for only 10-15% of all primary central nervous system (CNS) tumours. Most spinal tumours in pregnant women have been described as meningiomas or vascular tumours. We present the unique case of a pregnant patient presenting with a CD 99+ primary spinal centra...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688697.2017.1302073

    authors: Soni AJ,Modi G,Soni Z,Kotzen J,Soni Z,Goolab V

    更新日期:2019-06-01 00:00:00

  • Listeria monocytogenes encephalitis: an unusual cause of reversible confusion in a patient with glioblastoma multiforme.

    abstract::Confusion frequently occurs in patients with gliomas for a number of reasons. One cause is a superimposed intracerebral infection. The case of a 73-year-old man who deteriorated after debulking of a high-grade glioma is described. However, he was successfully treated for Listeria monocytogenes (L. monocytogenes) diagn...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688697.2010.535927

    authors: Kalsi P,Tizzard S

    更新日期:2011-06-01 00:00:00

  • The autoimmune basis of hypopituitarism in traumatic brain injury: fiction or reality?

    abstract::Post-traumatic hypopituitarism has remained as an obscured cause of worsening morbidity and mortality in head injury patients. Researchers have for decades been puzzled by the mechanism of pituitary dysfunction in these cases. Amongst other causes like direct injury, vascular injury etc, an immunological basis of hypo...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688697.2018.1485875

    authors: Harsh V,Jha S,Kumar H,Kumar A

    更新日期:2019-02-01 00:00:00

  • Muscle and nerve biopsy for the neurosurgical trainee.

    abstract:BACKGROUND:Nerve and muscle biopsy are common procedures often performed by junior surgical trainees. This educational review article describes the operative details of performing biopsies of muscle and nerve. Indications, pre-operative investigations and complication rates are described to aid in proper patient select...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章,评审

    doi:10.3109/02688697.2013.793288

    authors: Hart MG,Santarius T,Trivedi RA

    更新日期:2013-12-01 00:00:00

  • Subependymoma of the lateral ventricle: case report and literature review.

    abstract::A case is presented of a 35-year-old man, who suffered intermittent hydrocephalic attacks due to a large subependymoma arising within the left lateral ventricle. The sparse literature on this rare tumour is reviewed. ...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章,评审

    doi:10.3109/02688699409002398

    authors: Iqbal Z,Sutcliffe JC

    更新日期:1994-01-01 00:00:00

  • Sciatic schwannoma spanning the sciatic notch: removal by an anterior, transabdominal approach.

    abstract::We describe a sciatic schwannoma spanning the sciatic notch in a 39-year-old woman with persistent pelvic pain after caesarean delivery. The tumour was detected by pelvic CT scan and MRI. Anterior transabdominal surgery allowed the en bloc removal of both the pelvic and the buttock component of the tumour. ...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688690600603776

    authors: Consales A,Poppi M,Stumpo M

    更新日期:2006-02-01 00:00:00

  • Osteomyelitis of the skull vault from a human bite.

    abstract::We report a case of extensive osteomyelitis of the skull vault from a human bite. The presentation and surgical management of this unusual condition is described. The microbiological findings are comparable to known patterns of infection after human bites. Surgical management and prophylaxis after this injury are disc...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688699746582

    authors: Phillips NI,Robertson IJ

    更新日期:1997-04-01 00:00:00

  • Spinal arteriovenous malformations and subarachnoid haemorrhage.

    abstract::Seventy patients with spinal arteriovenous malformations (AVMs) referred to the author over a 25-year period (1958-82), were equally divided between congenital, intradural and acquired, dural lesions. Amongst the intradural AVMs, were 22 with subarachnoid haemorrhage (SAH), a presenting feature in 18. The clinical fin...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688699209002895

    authors: Shephard RH

    更新日期:1992-01-01 00:00:00

  • Creatine kinase (CK-BB) determination in cerebrospinal fluid after acute experimental head injury.

    abstract::Early changes of the activity of enzymes such as creatine kinase in the cerebrospinal fluid (CSF) or serum are often investigated after head injuries to assess the extent of brain damage and establish a reliable prognosis. The purpose of the present study was to determine levels of creatine kinase isoenzyme CK-BB in t...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.3109/02688698808992666

    authors: Anagnostopoulos DI,Dontas IA,Kotsarelis DV,Julien G,Karayannacos PE,Diakolios CE,Skalkeas GD

    更新日期:1988-01-01 00:00:00

  • The treatment of nosocomial meningitis and brain abscess by carbapenem-resistant Klebsiella pneumonia.

    abstract::We report the fourth case of Carbapenem-resistant Klebsiella pneumoniae (CRKP) meningitis and the only one associated with brain abscess formation. A 29-years-old male patient developed septic shock 13 days after a right nasopharyngeal AVM resection. CRKP was grown from CSF with a MIC for meropenem ≥16 mg/L. Intraveno...

    journal_title:British journal of neurosurgery

    pub_type: 杂志文章

    doi:10.1080/02688697.2018.1530729

    authors: Chen Y,Liu L

    更新日期:2019-07-25 00:00:00