Pituitary adenoma apoplexy presenting with bilateral third nerve palsy and bilateral proptosis: a case report

To report a case of pituitary adenoma apoplexy presenting with bilateral proptosis and bilateral third nerve palsy that developed after cardiovascular surgery. A 45-year-old man developed bilateral proptosis and bilateral third nerve palsy after a coronary artery bypass grafting operation. A pituitary macroadenoma with extension into the sphenoid sinus and cavernous sinus with bilateral involvement was resected on computed tomography scan by microscopic transsphenoidal procedure. Third nerve palsy improved partially on the first postoperative day and completely improved in the fourth month after the operation. This is a rare case of pituitary adenoma apoplexy that presented with bilateral third cranial nerve palsy

Peripheral blood monocytes in multiple sclerosis exacerbations

Monocytes [MO], macrophages, and microglia have a central role in the central nervous system inflammation of multiple sclerosis [MS]. During clinical activity in MS, MO activation markers increase and some interleukins and tumor necrosis factor-alpha levels are elevated. Our aim was to determine levels of absolute MO count and percentage in peripheral blood of MS patients during the attacks. We assessed the percentage of MO by examining the blood smears in 28 patients with definite MS, in 20 patients with acute cerebrovascular disease [CVD] and in 20 healthy control subjects. The mean value of absolute MO count in MS patients, CVD and control groups were as 606.67 +/- 170.52, 746.50 +/- 414.76 and 360.00 +/- 109.54 respectively. The mean values of MO percentage in MS patients, CVD and control group were 8.34 +/- 2.61%, 5.56 +/- 2.48% and 5.36 +/- 1.50% respectively. The mean percentage of MO was significantly elevated in MS patients compared with the both groups of CVD and control [P<0.001]. Our results suggest a possible role of an increase in MO activation in the acute exacerbations of Multiple Sclerosis

Variants and deformities of atlas vertebrae in eastern Anatolian people

At the craniocervical junction, developmental anomalies of the atlas may produce clinical symptoms by compressing on the vertebral artery, particularly during extreme rotational movements of the cervical spine. The aim of the present study was to investigate several varieties and deformities of the atlas vertebra from the skeletal specimens of Eastern Anatolian people. This study was carried out over a 3-year period, 2000 through to 2002 in the Department of Anatomy, Firat, Yuzuncu Yil and Ataturk University, Turkey. Developmental anomalies and the variants of the first vertebrae were investigated on 86 atlas. Ponticulus posterior was observed with a low frequency on right as 2.3%. The bilateral localization was 10.5% and the left-side localization was 9.3%. Ponticulus lateralis showed an equal localization as 1.2% on the right, 1.2% on the left and 1.2% bilateral. In the present study, a complete subdivision of the joint surface was observed in 11 atlases [12.8%]. Processus infratransversarius atlantis with a frequency between 1.2-7%, arthrotic formation and corona atlantis peridentals in 8 cases [9.3%] were also found. The low frequency for fonticulus posterior might be peculiar to the population living in this area