Patterns of pituitary adenoma among adult Sudanese patients

The objective of this study is to determine the clinical presentation and hormonal secretions of patients with pituitary adenomas. This is a descriptive, prospective study on 53 adult Sudanese patients with pituitary adenoma. Only adults [16 years or more] were included. The study was conducted in Al-Shaab Teaching Hospital in the period from January 2001 to February 2007. Twenty eight [52.8%] patients were females and 25 [47.2%] were males. Their ages ranged between 16 -80 years [mean 40.8 +/- 15.6 years]. Twenty seven [50.9%] patients had functioning pituitary adenomas [FPA] and 26 [49.1%] patients had nonfunctioning pituitary adenomas [NFPA]. Hormonal secretion of the adenomas was found to be prolactin in 16 patients [14 females and 2 males], growth hormone in 8 patients [3 females and 5 males], ACTH in 2 patients [one female and one male] and TSH in one female. Macroadenoma was found in 44 patients [83%], while microadenoma was found in 9 patients. All non functioning adenomas were found to be macroadenomas, while functioning adenomas were found in 18 patients with macroadenoma and in 9 patients with microadenoma. In our series all NFPAS were macroadenomas. They were usually discovered late after assuming mass effect or incidentally on imaging for other reasons. Patients with functioning adenomas tend to present earlier with hormonal dysfunction and hence are diagnosed earlier before the tumors assume big sizes. Prolactin secreting tumors are the commonest among functioning pituitary adenomas and tend to predominate in females

Wilson's disease with extensive white and gray matter MRI abnormalities: a case report

Wilson disease is an autosomal recessive disease, characterized by excessive accumulation of copper in the body, particularly in the liver, brain, cornea and kidney, with variable clinical manifestations. The outcome of treatment depends on early diagnosis of the disease before major irreversible tissue destruction occurs. Early diagnosis might be difficult because of its diverse clinical manifestations. We herein report on a patient with severe clinical and imaging manifestations. The patient showed cerebral atrophy and extensive abnormalities in frontal lobes, the putamen, the thalami, cerebral peduncles and posterior aspects of the occipital lobes. Such wide spread changes involving the white matter as well as the gray matter is rarely reported

Intracranial meningioma: findings from Sudan

The objective of this article is to determine the pattern of neurological presentation of meningiomain adult Sudanese patients. In this study we described the clinical presentation and neuroimaging findings in fifty patients with Intracranial meningioma. In all patients the diagnosis was histologically verified. The age distribution of the patients ranged between 19 -70 years, the mean age was 44.5 +/- 13.33 years. Females were 36 [72%] and males 14 [28%]. Male: female ratio was 1:2.6. The presenting symptoms were headache and nausea in 37 [74%] patients, behavioral changes in 34 [68%], visual disturbance in 23 [46%], generalized seizure in 20 [40%], limb weakness in 20 [40%], vomiting in 13 [26%], speech disturbance in 13 [26%], sphincteric disturbances in 11 [22%], focal seizures in 10 [20%], anosmia in 4 [8%], and deafness in 2 [4%]. Meningiomas were located in anterior fossa in 18 patients [40%], parasagittal in 9 [20%], sphenoidal ridge in 8 [18%], posterior fossa in 7 [15.9%], lateral convexity in 5 [11.3%], olfactory groove in 4 [9%], middle fossa in 2 [4.5%] and supraseller area in one [2.2%]. All meningiomas enhanced with gadolinium. Peritumoural oedema was found in 24 [54.5%] patients, hydrocephalus in 11 [25%] and hyperostosis in 9 [20.5%] patients. It has been concluded that the clinical presentation and MRI findings did not differ much from what is reported worldwide

Invasive aspergillosis of paranasal sinuses: findings from the Sudan

The Sudan is endemic for Aspergillus species, especially Aspergillus flavus. They commonly invade the paranasal sinuses, but massive invasion of the brain in immunocompetent patients is rare. To describe the clinical presentation and MRI findings in immunocompetent patients with massive paranasal aspergillosis with extensive invasion of the brain. Four patients, who are negative for HIV and other immunocompromizing disorders were studied in this article. Two females 55 and 25 year old, 2 males 29 and 62 year old were described. All cases showed extensive invasion of the paranasal sinuses and the adjacent structures. Invasive paranasal Aspergillosis can affect immunocompetent patients and the commonest organism is Aspergillus flavus