Pituitary apoplexy in a patient with acute myeloid leukemia and thrombocytopenia.

We describe a 72-year-old woman with a history of acute myeloid leukemia who developed pituitary apoplexy associated with thrombocytopenia secondary to chemotherapy. She presented with new onset severe headache, nausea, vomiting and blurred vision. Initial physical examination was unremarkable. CT scan of the head was initially negative. Upon admission for further work up, She developed a high-grade fever, hypotension and obtundation. Subsequent physical examination revealed bitemporal visual fields defects and decreased visual acuity. Repeat imaging of head revealed a hemorrhagic pituitary mass compressing the optic chiasm. Laboratory results were compatible with the diagnosis of pan-hypopituitary syndrome. She received high dose steroids and was transferred for transnasal sphenoidotomy decompression surgery. The visual defects improved postoperatively. A literature review of Pituitary apoplexy is presented. Pituitary apoplexy secondary to thrombocytopenia has never been reported.

Paraganglioma of the cauda equina with associated intramedullary cyst: MR findings.

The MR imaging features of a paraganglioma of the cauda equina with associated spinal cord cysts are presented. MR imaging showed the tumor to be isointense with the spinal cord on all pulse sequences and to enhance homogeneously. The intramedullary cysts had increased signal intensity on proton density- and T2-weighted images, and involved the cervical and thoracic regions.

Melanocytoma of the cavernous sinus: CT and MR findings.

We present the CT, MR angiographic, and histologic findings of a rare primary meningeal melanocytoma of the cavernous sinus. The primary differential diagnosis is between a melanin-containing tumor and an extraaxial cavernous angioma. Radiologic imaging cannot distinguish between the less aggressive primary meningeal melanocytoma and the more aggressive meningeal melanoma.

Endoscopic treatment of a symptomatic pineal cyst: technical case report.

Symptomatic pineal cysts are rare and typically managed with an open surgical approach. We report the successful treatment of a symptomatic pineal cyst using a stereotactic endoscopic technique.

Nonvisualization of a large cerebral aneurysm despite high-resolution magnetic resonance angiography. Case report.

The use of magnetic resonance (MR) angiography as a safe, accurate, and reliable substitute for invasive cerebral arteriography has been anticipated as refinements in this technique are introduced. We present the case of an unruptured, 11-mm pericallosal arterial aneurysm not visualized on high-resolution MR angiography. Although this case may be atypical, we caution against complete reliance on this test for exclusion of the presence of cerebral aneurysms.

Adult spinal motoneurons remain viable despite prolonged absence of functional synaptic contact with muscle.

Several rat medial gastrocnemius (MG) motor axons were allowed to regenerate into normally innervated muscle. Under these conditions, synapse formation is known to be prevented by the existence of the original innervation of the host muscle. A study was made of the ability of the implanted spinal motoneurons to acquire and retrogradely transport horseradish peroxidase (HRP) injected into the host muscle at various postoperative intervals. HRP-labeled MG motoneurons on the implanted side were observed at postoperative intervals as long as 290 days. A comparison of the number of labeled MG motoneurons on the implanted side versus the number on the unoperated, control side indicated no significant differences. At all investigated postoperative intervals except the earliest (7 DPO), a significant decrease in the mean MG motoneuron soma cross-sectional area was observed relative to the unoperated, control side. Analysis of labeled motoneuron size distributions showed that postoperative atrophy of larger, presumably alpha, motoneurons occurred at a significantly faster rate than in smaller, presumably gamma, motoneurons. These results demonstrate that axotomized adult spinal motoneurons survive and remain viable for prolonged periods when denied the opportunity to reinnervate muscle but do so in an atrophied state. The results indicate further that alpha and gamma motoneurons differ quantitatively in their responses to peripheral axotomy.

Incidence of aphakic cystoid macular edema with the use of topical indomethacin.

A prospective, controlled study utilizing topical 1% aqueous indomethacin was employed in an attempt to determine the incidence of aphakic cystoid macular edema (ACME) following cataract surgery. The incidence of ACME in the indomethacin-treated group was significantly less than in the control group five weeks after cataract surgery (36% vs 18%; P less than 0.02). There was no significant difference in the two groups ten weeks after surgery when studied by fluorescein angiography (34.6% vs 21%; P less than 0.10). The biochemical and pharmacological rationale for the use of the antiprostaglandin indomethacin in the management of ACME was reviewed. This revealed sufficient experimental and clinical evidence for continued research in the area of prostaglandin inhibitors for the possible prevention or treatment of this disorder.