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Chinese Medical Journal 2007年第24期120卷 2341-2343页

作者： BAO Yi-jun LI Xin-guo JING Zhi-tao OU Shao-wu WU An-hua WANG Yun-jie Department of Neurosurgery First Hospital of China Medical University Shenyang 110001 China

Plituitary apoplexy is a rare clinical syndrome caused by acute enlargement of pituitary adenomas, which may be secreting or nonfunctioning, and symptomatic or asymptomatic, resulted from hemorrhage or infarction. Subarachnoid hemorrhage （SAH） is an unusual presentation in patients with pituitary apoplexy, and that following a head injury is more infrequently reported. Here, we report a case of pituitary apoplexy complicated with subarachnoid hemorrhage caused by an incidentaloma after head trauma in an aged man, who experienced a spontaneous regression of the tumor.

关键词： incidentaloma pituitary apoplexy subarachnoid hemorrhage

Clinical case discussions-Hypopituitarism and pituitary apoplexy caused by pituitary Adenomas

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Discussion of Clinical Cases 2015年第1期2卷 14-19页

作者： Gaisheng Tian Qinxue Li Dan Zhao Ying Wang Ruijing Yan Department of Geriatrics the Third Affiliated Hospital of Inner Mongolia Medical UniversityBaotouChina

A case of“Hypopituitarism and pituitary apoplex induced by pituitary Adenomas”was collected in the Third Affiliated Hospital of Inner Mongolia medical University Geriatric Department.A rare and atypical disease as it is,delayed diagnosis and treatment is easily seen among those ***,the paper aims to investigate the difference of clinical characteristics and treatment outcome of pituitary adenomas in elder patient through the case ***,patients with pituitary dysfunction may have life-threatening crisis so that timely diagnosis and aggressive treatment can be effective in reducing the pituitary crisis and reducing the misdiagnosis rate.

关键词： pituitary tumor pituitary dysfunction pituitary apoplexy

Diagnosis and management of pituitary apoplexy:a Tunisian data

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Chinese Neurosurgical Journal 2023年第3期9卷 183-189页

作者： Faten Hadj Kacem Oumeyma Trimeche Imen Gargouri Dhoha Ben Salah Nadia Charfi Nabila Rekik Fatma Mnif Mouna Mnif Mouna Elleuch Mohammed Abid Hedi Chaker Hospital 3029 SfaxTunisia

Background pituitary apoplexy(PA)is defined as the hemorrhage or the infraction of a pituitary *** to determine the epidemiological,clinical,paraclinical characteristics as well as management and outcomes of PA in our population,we conducted this cross-sectional *** This cross-sectional study was conducted at the Department of Endocrinology of Hedi chaker university hospital,*** was collected from medical charts of patients with pituitary apoplexy admitted in our department between 2000 and *** We included 44 patients with *** mean age was 50±12.6 *** them,31.8%had a known pituitary adenoma,and it was in all cases a macroadenoma,predominantly a prolactin secreting tumor(42.8%).A triggering factor of PA was encountered in 31.8%of cases and it was mainly:head trauma,dopamine antagonists,and *** clinical presentation of PA encompassed headaches(84.1%),visual disturbances(75%),and neurological signs(40.9%).Gonadotropin deficiency was the most frequent form of hypopituitarism noted(59.1%),followed by corticotropin deficiency(52.3%),thyrotropin deficiency(47.7%),and somatotropin deficiency(2.3%).Hormonal assessment at PA onset,concluded that 23 had a secreting adenoma:18 prolactinomas,3 ACTH-secreting adenomas,and 2 GH-secreting *** the 21 remaining cases,the tumor was non-functioning(47.7%).pituitary MRI was performed in 42 cases(95.5%),revealing infraction and or hemorrhage in the pituitary gland in 33 cases;a heterogenous signal or a fluid level within the adenoma,in nine *** administration of intra venous hydrocortisone was required in 19 *** administration was mandatory in a patient who had severe intracranial *** management of the PA was imperative in 24 patients(54.5%):15 suffered from severe visual impairment,4 had an intracranial hypertension,2 cases demonstrated an impaired consciousness,2 patients experienced a tumor enlargement and one case had a severe

关键词： pituitary apoplexy pituitary neoplasms Neurosurgery Dopamine antagonists

Presurgical serum prolactin level: an early severity and prognostic marker of pituitary apoplexy

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Presurgical serum prolactin level: an early severity and pro...

Gonadotrophin-releasing hormone agonist-induced pituitary adenoma apoplexy and casual finding of a parathyroid carcinoma:A case report and review of literature

2015浙江省神经外科学学术年会暨浙闽江赣四省神经外科学术交流会

作者： Wei Yan Dong-Dong Zhao Ming-Fei Zhao Feng Cai Yong-jie Wang Fei-Qiang Ma Fang-Jie Shao Qun Wu Gao Chen Jian-min Zhang Department of Neurosurgery Sir Run Run Shaw HospitalSchool of MedicineZhejiang University Department of Infection Sir Run Run Shaw HospitalSchool of MedicineZhejiang University Department of Emergency The Second Affiliated HospitalSchool of MedicineZhejiang University

Objective: To review clinical presentation and surgical outcome of pituitary apoplexy and to explore the clinical significance of presurgical serum prolactin ***: Clinical, diagnostic and therapeutic data were collected from pituitarypatients admitted to our hospital from October, 2010 to October, 2012. pituitary apoplexy patients were followed up for an average of 440 days. Special attention was paid to the relation between presurgical serum prolactin level and illness severity or ***: 545 pituitary tumor patients were admitted to our hospital during that period, including 38 pituitary apoplexy cases. 9 out of 17 patients in low prolactin level group acquired severe visual impairment, comparing with only 2 out of 21 patients in normal or high prolactin level group(P pituitary apoplexy.

关键词： pituitary apoplexy Prolactin pituitary function Visual function

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World Journal of Clinical Cases 2019年第20期7卷 3259-3265页

作者： Vanessa Trivino Olga Fidalgo Antía Juane Jorge Pombo Fernando Cordido Department of Endocrinology Complejo Hospitalario Universitario A CorunaA Coruna 15006Spain Department of pathological anatomy Complejo Hospitalario Universitario A CorunaA Coruna 15006Spain

BACKGROUND pituitary apoplexy represents one of the most serious,life threatening endocrine emergencies that requires immediate ***-releasing hormone agonist(GnRHa)can induce pituitary apoplexy in those patients who have insidious pituitary adenoma *** SUMMARY A 46-year-old woman,with a history of hypertension and menorrhagia was transferred to our hospital from a secondary care hospital after complaints of headache and vomiting,with loss of consciousness 5 min after an injection of *** drug was prescribed by her gynecologist due to the presence of uterine *** clinical neurological examination revealed right cranial nerve III palsy,ptosis and movement limitation of the right *** first clinical consideration was a pituitary *** hormonal analysis revealed mild hyperprolactinemia and high follicle stimulating hormone level;PTH and calcium was high with glomerular filtration rate mildly to moderately decrease.A computed tomography scan,revealed an enlarged pituitary gland(3.5 cm)impinging upon the optic chiasm with bone involvement of the *** contrast media administration,the lesion showed homogeneous enhancement with high-density focus that suggests hemorrhagic infarction of the *** endoscopic surgery was perfomed and adenomatous tissue was *** was positive for luteinizing hormone(LH)and follicular-stimulating hormone(FSH).A solid hypoechoic nodule(14 mm x 13 mm x 16 mm)was found in the caudal portion of the right thyroid lobe after a parathyroid ultrasound.A genetic test of Multiple Endocrine Neoplasia type 1(MEN1)was negative.A right lower parathyroidectomy was performed and the pathologic study showed the presence of an encapsulated parathyroid carcinoma of 1.5 cm.A MEN type 4 genetic test was performed result was *** This case demonstrates an uncommon complication of GnRH agonist therapy in the setting of a pituitary macroadenoma an

关键词： pituitary apoplexy pituitary adenoma Primary hyperparathyroidism MEN type 1 MEN type 4 Parathyroid carcinoma Case report

pituitary macroadenoma apoplexy as a rare complication of Bruton tyrosine kinase inhibitor in chronic lymphoid leukaemia

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Chinese Neurosurgical Journal 2023年第4期9卷 320-325页

作者： Aysha Gomaa Robert Skelly East Sussex Healthcare NHS Trust EastbourneUK East Suffolk and North Essex NHS Foundation Trust ColcchesterUK

Background pituitary apoplexy is a neurosurgical emergency and is a known yet rare complication of pituitary *** typically present with visual field defects,headache and altered *** are multiple risk factors for this complication and a thorough drug history is essential to exclude iatrogenic causes of *** present an extremely rare case of newly diagnosed pituitary insufficiency unveiled by ibrutinib therapy(a Bruton tyrosine kinase inhibitor).Furthermore,after initial withdrawal of ibrutinib because of the erroneous diagnosis of Syndrome of Inappropriate Antidiuretic Hormone Secretion(SIADH),its re-administration led to the development of classical pituitary apoplexy 4 months after treatment was *** presentation A male patient in his 60s with a background of chronic lymphocytic leukaemia(CLL)on ibrutinib and venetoclax presents with acute confusion and deranged *** is found to be hyponatraemic and is diagnosed with Syndrome of Inappropriate Antidiuretic Hormone Secretion(SIADH)and treated with fluid *** represents again 3 weeks later with hyponatraemia and further investigations reveal pituitary insufficiency and *** was restarted on ibrutinib and venetoclax at the time of *** months later,he presents with sudden retro-orbital headache associated with *** findings include cranial nerve III,IV and XI ***’s visual field examination revealed a left visual field index(VFI)of only 1%while the right was 64%with temporal *** pupils were mid-dilated and poorly reactive to *** pituitary with contrast showed features of pituitary apoplexy and optic nerve *** was urgently referred to the neurosurgical team and underwent an emergency trans-sphenoidal hypophysectomy with circumferential excision of the ***-operative recovery was uneventful with marked improvement in vision *** patient was restarted on ibruti

关键词： pituitary apoplexy pituitary macroadenoma Chronic lymphocytic leukaemia Chemotherapy

Risk factors for the incidence of apoplexy in pituitary adenoma: a single-center study from southwestern China

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Chinese Neurosurgical Journal 2020年第4期6卷 224-229页

作者： Yao Li Yuan Qian Yisheng Qiao Xiaoxiang Chen Jiaotian Xu Chao Zhang Wei Wang Junjun Li Xingli Deng Department of Neurological Surgery 1st Affiliated Hospital of Kunming Medical UniversityKunmingChina Yunnan Key Laboratory of Laboratory Medicine Yunnan Engineering Technology Center of Digestive disease1st Affiliated Hospital of Kunming Medical UniversityKunmingChina Department of Medical Genetics and Prenatal Diagnosis Kunming Maternal and Child Health HospitalKunmingChina

Background:Although the incidence and clinical manifestations of pituitary apoplexy were reported by a few researches,the results are not *** study aimed to explore the risk factors associated with an incidence of apoplexy in pituitary ***:The clinical information of 843 patients with pituitary adenoma from the Department of Neurological Surgery,1st Affiliated Hospital of Kunming Medical University,was *** incidence,clinical manifestation,and potential risk factors for pituitary apoplexy were analyzed by a case-control ***:In total,121 patients(14.4%)with macroadenoma were suffered from pituitary ***,vomiting,and visual impairment are the top 3 symptoms for the pituitary *** regression results showed that the hypertension(hypertension vs non-hypertension OR=2.765,95%CI:1.41~5.416),tumor type(negative staining *** staining,OR=1.501,95%CI:1.248~5.235),and tumor size(diameter>2 cm ***≤2 cm,OR=3.952,95%CI:2.211~7.053)are independent factors associated with pituitary ***:Our results indicate that the risk factors for the incidence of pituitary apoplexy depend mainly on properties of the tumor itself(tumor size and pathologic type)and the blood pressure of patients.

关键词： pituitary adenoma pituitary apoplexy Risk factors

Dynamical network biomarkers for identifying critical transitions and their driving networks of biologic processes

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Frontiers of Electrical and Electronic Engineering in China 2013年第2期8卷 105-114页

作者： Rui Liu Kazuyuki Aihara Luonan Chen Department of Mathematics South China University of Technology Guangzhou 510640 China Collaborative Research Center for Innovative Mathematical Modeling Institute of Industrial Science University of Tokyo Tokyo 153-8505 Japan Key Laboratory of Systems Biology SIBS-Novo Nordisk Translational Research Centre for PreDiabetes Shanghai Institutes for Biological Sciences Chinese Academy of Sciences Shanghai 200031 China

Non-smooth or even abrupt state changes exist during many biological processes, e.g., cell differentiation processes, proliferation processes, or even disease deterioration processes. Such dynamics generally signals the emergence of critical transition phenomena, which result in drastic changes of system states or eventually qualitative changes of phenotypes. Hence, it is of great importance to detect such transitions and further reveal their molecular mechanisms at network level. Here, we review the recent advances on dynamical network biomarkers （DNBs） as well as the related theoretical foundation, which can identify not only early signals of the critical transitions but also their leading networks, which drive the whole system to initiate such transitions. In order to demonstrate the effectiveness of this novel approach, examples of complex diseases are also provided to detect pre-disease stage, for which traditional methods or biomarkers failed.

关键词： Biologic Process Center Manifold Theory Critical Transition pituitary apoplexy Tipping Point