Neuroendocrinol Lett
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Neuroendocrinol Lett · Jan 2012
Clinical TrialIntermittent subcutaneous morphine regimen for postoperative pain management following abdominal hysterectomy regarding morphine- and beta-endorphin systemic concentrations.
Systemic β-endorphin, an endogenous opioid and stress hormone, has been demonstrated to correlate with the postoperative pain intensity, however its putative role as a postoperative pain biomarker has not been cleared. ⋯ Systemic β-endorphin is not an appropriate pain marker in postoperative gynaecologic patients.
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Neuroendocrinol Lett · Jan 2012
Case ReportsHypothalamic dysfunctions as a late consequence of surgical opening of the lamina terminalis. A controversial hypothesis.
Opening of the lamina terminalis is often used in surgery of the optico-chiasmatic region. Consequently, alteration of cerebral-spinal fluid (CSF) dynamics can occur after this manoeuvre, thus potentially translating into clinical complications. Herein, we describe 2 cases in which clinically relevant hypothalamic dysfunctions developed after few days opening of the lamina terminalis both patients showed mild to moderate preoperative hydrocephalus which improved postoperatively. ⋯ Our experience may suggest that hypothalamic dysfunctions should be reminded as a possible, although rare, complication following the opening of the lamina terminalis. This clinical condition, if not properly managed, may contribute to trigger severe life-threatening complications.
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Neuroendocrinol Lett · Jan 2012
Case ReportsTranssphenoidal surgery for a life-threatening prolactinoma apoplexy during pregnancy.
Prolactinoma is the most common secreting pituitary adenoma. It is typically diagnosed in women of reproductive age and is common cause of infertility. Currently the treatment of choice is pharmacotherapy with dopamine agonists, whereas surgical treatment is reserved for a selected group of patients. ⋯ Magnetic resonance imaging (MRI) did not reveal tumor re-growth. The patient is kept under constant medical care. In this case study the authors discussed therapeutic management and reviewed literature regarding gestational pituitary-tumor apoplexy with particular emphasis on surgical treatment.
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Neuroendocrinol Lett · Jan 2012
Case ReportsNeuronavigation used for the transsphenoidal resection of a pituitary adenoma accompanied by a concha sphenoid sinus.
A concha non-pneumatized sphenoid is considered to be a contraindication for the transsphenoidal resection of a pituitary adenoma. Specifically, this anatomical variation makes it difficult to approach the sella turcica. However, in this report, an intra-operative navigational system was used as a guide to access the sella through the sphenoid sinus. This procedure was found to be both reasonable and safe.
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Neuroendocrinol Lett · Jan 2012
Case ReportsHypnic headache - a rare primary headache disorder with very good response to indomethacin.
Hypnic headache (HH) is considered as a disorder of the circadian rhythm, mostly affecting the elderly and generally considered a benign disorder, but the pathophysiology of hypnic hedache remains unclear. Various treatments have been suggested for hypnic headache, especially lithium and indomethacin. We report the case of HH fulfilling The International Classification Headache Disorders, 2nd edition criteria (ICHD-II). ⋯ On day 60 the treatment was stopped. 30 months after day 60, the patient was still headache free. We reported the first Czech patient with HH with very good therapeutic response to indomethacin. The effect of therapy with indomethacin 50mg BID was very fast and stable.