Clinical Research Papers:
Clinical features and management of nonfunctioning giant pituitary adenomas causing hydrocephalus
Metrics: PDF 1171 views | HTML 1847 views | ?
Danfeng Zhang1*, Jigang Chen1*, Zhenxing Li1*, Junyu Wang1, Kaiwei Han1 and Lijun Hou1
1Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai, 200003, China
*These authors contributed equally to this work
Lijun Hou, email: [email protected]
Kaiwei Han, email: [email protected]
Junyu Wang, email: [email protected]
Keywords: nonfunctioning giant pituitary adenomas; hydrocephalus; clinical features; management; surgical approach
Received: July 31, 2017 Accepted: December 05, 2017 Epub: January 11, 2018 Published: March 16, 2018
We evaluated the features of clinically nonfunctioning giant pituitary adenomas (NFGPAs) causing hydrocephalus to highlight the timing of hydrocephalus management and surgical approaches. A total of 24 patients with NFGPAs and hydrocephalus were included. Eighteen patients underwent endoscopic transsphenoidal surgery. Ten patients received pterional surgery, including 6 patients as first treatment and 4 cases with recurrence after transsphenoidal approach. Gross total resection was achieved in 10 patients, including 6 cases (6/18, 33.3%) with endoscopic transsphenoidal surgery and 4 cases (4/10, 40%) with pterional surgery. All patients were divided into preoperative EVD group and non-preopoerative EVD group. The proportion of patients receiving postoperative EVD or shunt was significantly higher in non-preoperative EVD group than that in preoperative EVD group (9/15 vs. 1/9, P = 0.033). Visual impairment score (VIS) was evaluated for each patient. We detected significant vision improvement according to the preoperative and postoperative VIS (median, interquartile range: 62, 48.25–77 vs. 36.5, 0–50.75, P < 0.001). Conclusively, for patients with NFGPAs and hydrocephalus, preoperative EVD might reduce the need for a second shunt or EVD. Surgical approach should be decided based on the clinicoradiological features and surgeons’ experience for individualized treatment, and endoscopic transsphenoidal resection of pituitary adenomas was suggested for most NFGPAs.
All site content, except where otherwise noted, is licensed under a Creative Commons Attribution 4.0 License.