A5044526995- Pituitary Gland Disorders and Treatments
- Meningioma and schwannoma management
- Growth Hormone and Insulin-like Growth Factors
- Glioma Diagnosis and Treatment
- Cerebrospinal fluid and hydrocephalus
- History of Medical Practice
- Adrenal and Paraganglionic Tumors
- Head and Neck Surgical Oncology
- Neurology and Historical Studies
- Ophthalmology and Eye Disorders
- Spinal Dysraphism and Malformations
- Traumatic Brain Injury and Neurovascular Disturbances
- Medical History and Innovations
- Neurofibromatosis and Schwannoma Cases
- Migraine and Headache Studies
- Infectious Diseases and Tuberculosis
- Sinusitis and nasal conditions
- Myasthenia Gravis and Thymoma
- Empathy and Medical Education
- Traumatic Brain Injury Research
- Radiomics and Machine Learning in Medical Imaging
- Cancer, Hypoxia, and Metabolism
- Neurosurgical Procedures and Complications
- Spinal Hematomas and Complications
- Management of metastatic bone disease
Pacific Northwest National Laboratory
2024
University College London
2011-2022
National Hospital for Neurology and Neurosurgery
2011-2022
Royal London Hospital
2017
Victor (Japan)
2003-2008
Dà-Jiāng Innovations Science and Technology (China)
2005
Minami Kyushu Junior College
2005
University College Hospital
1999
Middlesex Hospital
1997
North Middlesex Hospital
1987-1996
Classical pituitary apoplexy is a medical emergency and rapid replacement with hydrocortisone maybe life saving. It clinical syndrome characterized by the sudden onset of headache, vomiting, visual impairment decreased consciousness caused haemorrhage and/or infarction gland. associated headache accompanied or not neurological symptoms involving second, third, fourth sixth cranial nerves. If diagnosed patients should be referred to multidisciplinary team comprising, amongst others,...
The clinical characteristics of 84 patients with pituitary tumour who had troublesome headache were investigated. presented chronic (46%) and episodic (30%) migraine, short-lasting unilateral neuralgiform attacks conjunctival injection tearing (SUNCT; 5%), cluster (4%), hemicrania continua (1%) primary stabbing (27%). It was not possible to classify the according International Headache Society diagnostic criteria in six cases (7%). Cavernous sinus invasion present minority presentations...
OBJECTIVE: This is a retrospective study of series 28 Rathke's cleft cysts operated on transsphenoidally that was undertaken for the following reasons: 1) to presentation, with particular reference hormonal and visual disturbances; 2) postoperative improvements in endocrine function vision; 3) record complications; 4) assess efficacy minor modification standard transsphenoidal surgical technique, whereby cyst allowed drain directly into sphenoid air sinus without fossa floor repair when...
Context:Pituitary adenomas and pheochromocytomas/paragangliomas (pheo/PGL) can occur in the same patient or family. Coexistence of two diseases could be due to either a common pathogenic mechanism coincidence.
Sixty-six patients had surgery for an intramedullary nerve sheath tumour under the care of one surgical team in a 16-year period. Surgery concentrated on radical intra- and extradural excision combined if necessary with vertebral column reconstruction. Ninety procedures were used 35 males 30 females age range 12-81 years. Forty-five per cent located cervical, 26% thoracic 29% lumbosacral region. Eighteen NF1 two NF2. Sixty-five schwannomas, 27% mixed histology 6% malignant. In terms...
Background: Pituitary tumors are commonly associated with disabling headache.The accepted mechanisms for headache dural stretch and cavernous sinus invasion.Objective: To determine if there is a relationship between pituitary tumor size the report of headache.Design: We prospectively studied 63 patients who were initially seen tumors.Clinical scores, volume, extent invasion obtained each patient.Results: The prevalence was 70%.There no positive correlation clinical head-ache score volume...
Eighteen patients with a colloid cyst of the 3rd ventricle presented to Frenchay Hospital Neurosurgery Unit. The investigations included computed tomography (CT). Of these patients, 9 had radiographically isodense cysts that caused considerable diagnostic difficulties, being described only as an anterior ventricular space-occupying lesion and lateral dilatation in all but 2 cases. clinical findings are CT appearance is discussed. new use ventriculoscopy may resolve problem rapidly; made...
In a prospective trial we performed MRI of the spine and hind brain in 31 patients with scoliosis onset between ages four 12 years. eight (26%) there was significant neuroanatomical abnormality; were six cases Chiari-1 malformation associated syrinx, one isolated astrocytoma cervical spine. Four these had left-sided curves. There no clinical features which could reliably identify those abnormalities on MRI. particular, unilateral absence abdominal reflexes found to be non-specific (1 8...
We present the first case of pituitary carcinoma occurring in a patient with succinate dehydrogenase subunit B (SDHB) mutation and history paraganglioma. She was initially treated for glomus tumour external beam radiotherapy. Twenty-five years later, she diagnosed non-functioning adenoma, having developed bitemporal hemianopia. Recurrence lesion (Ki-67 10% p53 overexpressed) occurred 5 after her transsphenoidal surgery, which underwent two further operations followed by Histology showed...
See Fig. 1 for an emergency management summary. Open in a separate window Figure 1 Pituitary apoplexy
Silent corticotroph adenomas (SCA) are pituitary tumours positive on immunohistochemical staining for ACTH but without clinical evidence of Cushing's disease in the patient. Previous reports suggest that these may behave a more aggressive way then other adenomas. We have followed natural history SCA and assessed whether histopathological indices predict tumour behaviour. identified 22 patients whom trans-sphenoidal surgery was performed non-functioning adenoma (NFA) with immunostaining...
The results of surgical management in 54 patients with intramedullary spinal cord tumours are presented. Cervical were most frequent (25/54) followed by thoracic (16/54) and then lumbar (14/54). Ependymomas astrocytomas the common tumour types. Total removal was possible just over half cases. Surgical complications included: two deaths, six CSF leaks one wound infection. Postoperatively three had worsening their motor deficit (unable to walk) urinary sphincter function. Conversely, who...
SUMMARY Cortical oxygen utilization, extraction, blood flow, and volume, have been measured in patients with hydrocephalus before after surgical decompression using positron emission tomography (PET). The subjects fell into two categories: recent-onset obstructive symptoms of raised intracranial pressure due to obstruction cerebrospinal fluid (CSF) drainage by posterior fossa or third ventricular cerebral tumours, more insidious onset that was associated either congenital abnormalities,...
Study Design One hundred fifteen patients having symptomatic cervical disc disease were recruited prospectively for this study. They allocated randomly either autologous iliac bone graft or biocompatible osteoconductive polymer implants. Both groups compared clinically and radiologically. Objectives Complications, long-term clinical radiologic outcome, hospital stay to determine if was an improvement on in terms of reduced donor site pain shortened stay. Summary Background Data Donor...
We describe three unusual tumours characterized by a mixture of glial and neuronal differentiation, involvement the posterior fossa formation rosettes. Mixed glial-neuronal are rare poorly described neoplasms. However, several distinctive entities have appeared in literature over recent years under variety different names. Our cases demonstrate morphological features 'rosette-forming glioneuronal tumour fourth ventricle', recently identified characterised its unique location, neurocytic...
Study Design. A single case study was conducted. Objectives. To detail the occurrence of multiple intracranial, intraparenchymal hemorrhages following an iatrogenic acute reduction in cerebral spinal fluid pressure excision intradural extramedullary tumor. Summary Background Data. Multiple supratentorial, intraparenchymal, intracranial have not been previously reported literature. Methods. report and literature review are presented. Results. The patient made uneventful full recovery....
<h3>OBJECTIVES</h3> Transsphenoidal surgery (TSS) is the preferred method for excision of pituitary microadenomas in adults. This study was carried out to establish long term efficacy and safety TSS children. <h3>STUDY DESIGN</h3> A 14 year retrospective analysis on 23 children (16 boys seven girls), all less than 18 years age, who had undergone at our centre. <h3>RESULTS</h3> Twenty nine transsphenoidal surgical procedures were out. The most common diagnosis an adrenocorticotrophic hormone...
OBJECTIVE Dopamine agonists are the primary therapeutic modality for majority of patients with prolactinomas, pituitary surgery reserved those intolerant or resistant to these agents. Most published surgical series, however, contain treated by as modality. Previous exposure dopamine selection prolactinomas conventional therapy may potentially compromise success rate. The purpose this study was evaluate efficacy and safety in a tertiary referral centre where were operated on after treatment...
Abstract The ACTH receptor (ACTH-R) is the second member of melanocortin (MC-2) family that includes five seven-transmembrane G protein-coupled receptors and has been shown to be predominantly expressed in adrenal cortex. It postulated may regulate its own secretion through ultra-short-loop feedback within pituitary. ACTH-secreting adenomas are characterized by resistance glucocorticoid feedback, they have dysregulated feedback. We therefore investigated ACTH-R normal adenomatous human...
✓ A comparison of intraventricular pressure (IVP) and extradural (EDP) was carried out in 17 patients being investigated for normal-pressure hydrocephalus, six with acutely raised intracranial following events such as head injury or intracerebral hematoma. Extradural measured using the CardioSearch monitor. There a reasonably good correlation between EDP IVP chronic stable group pressures up to 25 mm Hg. In acute there no predictable relationship IVP, during 24-hour period could vary by much...
Summary Objective It has been reported that both normal pituitary and tumours express PPAR‐γ, a nuclear hormone receptor, the expression being more abundant in tumours, this is basis for antiproliferative effects of thiazolidinedione, rosiglitazone, animal models. However, mechanisms responsivity to rosiglitazone have remained unclear. Design measurements To investigate further, ‘real‐time’ PCR was used assess PPAR‐γ mRNA expression, Western blotting immunohistochemistry study its protein 46...
OBJECTIVE We sought to study the yield of olfactory ensheathing cells from biopsies mucosa nasal septum. These specialized encourage regeneration nerves central nervous system and may be value for spinal cord nerve injuries. METHODS undertook a prospective observational by endonasal dissection septum during approach routine transsphenoidal surgeries. Samples were cultured in laboratory, was compared as location, size, weight age patients. RESULTS A better obtained areas that more superior...
Summary objective Clinical acromegaly is characterized by elevated GH secretion in the presence of high circulating IGF‐I levels. We hypothesized that physiological IGF‐I/GH negative feedback loop may be reset somatotroph adenomas, specifically terms level expression these receptors or mutations receptor (GH‐R) such tumours. methods therefore investigated full coding sequence GH‐R a series and other pituitary adenomas. also mRNA putative adenomas normal tissue, their protein immunostaining....