Delayed Occurrence of Diabetes Insipidus After Transsphenoidal Surgery with Radiologic Evaluation of the Pituitary Stalk on Magnetic Resonance Imaging

フォーマット:

論文

責任表示:

Hayashi, Yasuhiko ; Aida, Yasuhiro ; Sasagawa, Yasuo ; Oishi, Masahiro ; Kita, Daisuke ; Tachibana, Osamu ; Ueda, Fumiaki ; Nakada, Mitsutoshi ; 林, 康彦 ; 笹川, 泰生 ; 大石, 正博 ; 中田, 光俊

言語:

英語

出版情報:

Elsevier Inc., 2018-02-01

著者名:

Hayashi, Yasuhiko

Aida, Yasuhiro

Sasagawa, Yasuo

Oishi, Masahiro

Kita, Daisuke

Tachibana, Osamu

Ueda, Fumiaki

Nakada, Mitsutoshi

林, 康彦

笹川, 泰生

大石, 正博

中田, 光俊

続きを見る

掲載情報:

World Neurosurgery

ISSN:

1878-8750      

巻:

110

開始ページ:

e1072

終了ページ:

e1077

バージョン:

author

概要:

金沢大学医薬保健研究域医学系<br />Background: Diabetes insipidus (DI) is a major complication of transsphenoidal surgery (TSS). DI usually occurs within a couple of days after TSS. Delayed occurrence of postoperative DI is rarely observed and its d … eveloping mechanisms remain unknown. Methods: Six patients were identified as having postoperative delayed DI, which was defined as DI that first occurred 2 or more weeks after TSS. They consisted of 1 male and 5 females, and their mean age was 38.3 years (range, 10–76 years). Five patients were histologically diagnosed with Rathke cleft cyst (RCC), and one had RCC coexisting with prolactin-secreting adenoma. Sequential T1-weighted magnetic resonance imaging was evaluated for hyperintensity (HI) in the pituitary stalk and the posterior lobe, indicating the location of antidiuretic hormone. Results: No patients had any DI before TSS. Delayed DI occurred 2 weeks to 3 months after TSS and persisted for 2 weeks to 5 months. T1-weighted magnetic resonance imaging showed that the HI in the posterior lobe became faint but did not disappear after DI occurrence, and their intensities increased with recovery from DI. In contrast, the HI in the pituitary stalk was found faintly preoperatively and turned clear postoperatively and decreased with recovery from DI. The morphologic patterns were dependent on DI duration. Conclusions: In the delayed occurrence of DI, it was suggested that preoperative antidiuretic hormone transport was mildly congested yet not completely blocked when DI manifested postoperatively. Gradual spreading of inflammation to the infundibulum after RCC removal was considered as 1 possible mechanism of this delayed DI development. © 2017 Elsevier Inc.<br />Embargo Period 12 months 続きを見る

URL:

http://hdl.handle.net/2297/00050512