ABSTRACT
Prolactinomas are common secretory pituitary tumours, usually managed with dopamine agonists. There have previously been case reports of rarer giant prolactinomas causing invasion of surrounding structures. We describe a case report of an exceptionally aggressive giant prolactinoma that eroded the occipital condyles causing cranio-cervical joint instability mandating surgical fixation.
Subject(s)
Cranial Nerve Diseases/etiology , Joint Instability/etiology , Pituitary Neoplasms/complications , Prolactinoma/complications , Adult , Antineoplastic Agents/therapeutic use , Arthrodesis , Cabergoline , Cervical Vertebrae/pathology , Cranial Fossa, Posterior/pathology , Cranial Nerve Diseases/diagnosis , Cranial Nerve Diseases/physiopathology , Cranial Nerve Diseases/rehabilitation , Craniotomy , Ergolines/therapeutic use , Humans , Hyperprolactinemia , Joint Instability/diagnosis , Joint Instability/surgery , Magnetic Resonance Imaging , Male , Neoplasm Invasiveness , Occipital Bone/pathology , Orthotic Devices , Pituitary Neoplasms/diagnosis , Pituitary Neoplasms/pathology , Pituitary Neoplasms/therapy , Prolactinoma/diagnosis , Prolactinoma/pathology , Prolactinoma/therapy , Recovery of Function , Treatment OutcomeABSTRACT
Characteristically continuous facial myokymia is a pathognomonic, exceedingly rare physical sign of intrinsic brain-stem lesions e.g. multiple sclerosis (where the myokymia lasts only for a few months), pontine glioma (where it is unremitting for years). The physiopathogenesis is unclear. Electromyographic patterns are characteristic. Therapy and prognosis are related to the basic aetio-pathological process. Only two out of 132 cases of intrinsic brain-stem lesions in the department of Neurosurgery, Seth G.s. Medical College, Bombay over a period of 3 decades, exemplify its rarity. These two cases are reported here and the relevant literature is reviewed.
Subject(s)
Brain Neoplasms/physiopathology , Brain Stem/physiopathology , Facial Muscles/innervation , Fasciculation/physiopathology , Glioma/physiopathology , Adult , Brain Neoplasms/radiotherapy , Cranial Irradiation , Electromyography , Evoked Potentials, Auditory, Brain Stem/physiology , Female , Glioma/radiotherapy , Humans , Male , Tomography, X-Ray ComputedABSTRACT
A case of late progressive myelo-radiculopathy associated with severe canal stenosis secondary to post-traumatic hypertrophy of thoracic laminae and ossification of spinal ligaments viz. ligamentum flavum and posterior longitudinal ligament in the absence of developmental spinal stenosis or post-traumatic deformity, is presented with a brief critical review of the relevant literature.
