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Pituitary emergencies:
Published in Nadia Barghouthi, Jessica Perini, Endocrine Diseases in Pregnancy and the Postpartum Period, 2021
Jessica Perini, Nadia Barghouthi, Gayatri Jaiswal
Pituitary apoplexy can present with severe, sudden headache, vision changes, lethargy, nausea, and vomiting. Both Sheehan’s syndrome and pituitary apoplexy can present with symptoms of adrenal insufficiency and inability to lactate.
Paper 2
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
Pituitary apoplexy is caused by pituitary necrosis, which may be haemorrhagic. This is frequently secondary to an underlying pituitary lesion, such as a macroadenoma. CT is insensitive for the diagnosis, and the pituitary fossa is better imaged with MRI. The pituitary may show high T1 signal if the cause is haemorrhagic; however, this will also depend on the age of blood, and other haemorrhagic/proteinaceous/necrotic masses can also have high T1 signal. Enhancement is typically peripheral and the infarcted centre commonly demonstrates restricted diffusion.
Current Status of Paragonimus and Paragonimiasis
Published in Max J. Miller, E. J. Love, Parasitic Diseases: Treatment and Control, 2020
The clinical feature of cerebral paragonimiasis are similar to those of Jacksonian epilepsy, cerebral tumor, or embolism in the brain, and the most conspicuous sign is paralysis. Often the disease is accompanied by apoplexy, but its progress is gradual.
Apoplexy in Richard Bright’s (1789–1858) reports of medical cases
Published in Journal of the History of the Neurosciences, 2021
Théophile Bonet (1620–1689) and his contemporaries thought of apoplexy as a disease with a “sudden abolition of all the activities of the mind, with the preservation, for a time, of the pulse and respiration” (Bonet 1700, 5). However, abrupt paralysis without the loss or impairment of consciousness or with a gradual rather than an abrupt onset was also widely regarded as a form of apoplexy by the scholars quoted by Bonet. Morgagni stated, “In apoplectic cadavers extravasated and coagulated blood and extravasated serum is present, hence apoplexy is sanguineous or serous.” Morgagni concluded that the causes for apoplexy were either the “extravasation or congestion of blood, or deposition of serum; hence the celebrated distinction of apoplexy into sanguineous and serous: but it will appear in the sequel, that apoplectic symptoms may arise from other lesions of the brain” (Morgagni 1769, Vol. I, 22). He added a third category of apoplexy in which neither hemorrhage nor an effusion of serum were found at autopsy (Morgagni 1769, Vol. I, 20).
Spontaneous preoperative pituitary adenoma resolution following apoplexy: a case presentation and literature review
Published in British Journal of Neurosurgery, 2020
Daniel G. Eichberg, Long Di, Ashish H. Shah, William A. Kaye, Ricardo J. Komotar
Pituitary adenomas are 5.4 times more likely to hemorrhage than any other brain tumor.32 The mechanism underlying apoplexy is not fully understood. The pituitary gland itself has a rich vascular supply and is fed by major vessels, such as the superior and inferior hypophyseal arteries.33 Several theories have been proposed regarding the pathophysiology of PA. Either primary hemorrhage or hemorrhagic infarction of a tumor can result in PA. Epstein et al. proposed that rapid tumor growth may outstrip arterial blood supply resulting in ischemia.34 While apoplexy does seem to occur more frequently in macroadenomas, even microadenomas can hemorrhage as was described in one of the cases by Yoshino et al.24 Alternatively, Rovit et al. posits that the mass effect of the growing tumor may compress the pituitary stalk against the diaphragma sella, thus compromising blood flow in the stalk’s fragile vascular network, thus leading to ischemia and hemorrhagic infarction.35
RVG29-modified microRNA-loaded nanoparticles improve ischemic brain injury by nasal delivery
Published in Drug Delivery, 2020
Rubin Hao, Bixi Sun, Lihua Yang, Chun Ma, Shuling Li
The treatment of cerebral apoplexy has always been clinically difficult, and the effects of conventional oral and intravenous treatments are unsatisfactory. The focus of cerebral apoplexy treatment is to protect normal brain tissue and promote the recovery of the ischemic penumbra near the infarcted area (Leigh et al., 2018). After cerebral infarction, the morphological structure of nerve cells changes, leading to a loss of function, but functional recovery can occur after a short period (Muzzi et al., 2019). Currently, the commonly used treatment method in clinical practice is chemical drug thrombolysis, but the effect is insufficient. Nucleic acid drugs have good pharmacodynamic effects, low toxicity, and few side effects. At present, treatment with nucleic acids has received increasing attention (Davide et al., 2019). MicroRNAs (miR) are short single-stranded RNAs with specific regulatory functions that can control signal pathways through a related network (Adlakha & Saini, 2014). MiR-124 is one of the most abundantly expressed miRNAs in the mature central nervous system (CNS) and is closely related to neuronal differentiation, maturation, and survival (Kozuka et al., 2019). In preclinical studies of neurological diseases, miR-124 is often used to assess neuroprotection and functional recovery after cerebral apoplexy (Hamzei Taj et al., 2016), and this molecule plays an important role in the plasticity of synaptic homeostasis (Hou et al., 2015).