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CC BY 4.0 · Indian Journal of Neurosurgery
DOI: 10.1055/s-0043-1778130
Brief Report

Unusual Presentations of Sellar and Suprasellar Space Occupying Lesion: Our Institutional Experience

Ramalingam Giridharan 
1   Department of Neurosurgery, Madurai medical College and Hospital, Madurai, Tamil Nadu, India
,
Nirmal Kumar
1   Department of Neurosurgery, Madurai medical College and Hospital, Madurai, Tamil Nadu, India
,
J. Srisaravanan
1   Department of Neurosurgery, Madurai medical College and Hospital, Madurai, Tamil Nadu, India
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Abstract

A pituitary abscess (PA) is a rare intracranial lesion. It is a critical disorder caused by an infectious process where purulent material accumulates inside the sella turcica. It occurs either as a primary disease or because of an infection and is associated with poor prognosis. In this article, we share our experience with PA. At our institution, we operated on five cases of pituitary abscess since 2016. All the cases presented with bitemporal hemianopia and headache. None of them had fever. Pituitary hormones were normal except in two patients with a previous history of hypothyroidism. Magnetic resonance imaging (MRI) of the brain showed pituitary macroadenoma. They underwent the endoscopic transnasal transsphenoidal approach. Postoperatively their vision has improved. Endocrine functions were normal in all the patients following surgery. Culture sensitivity was sterile in all the patients. Diagnosis of pituitary abscess is highly difficult before surgery. Hence, the diagnosis should be considered when a patient presents with fever, headache, and signs of pituitary dysfunction and meningeal inflammation. Surgical and medical management leads to a lower mortality rate and a higher probability of hormone function recovery.

Keywords

pituitary abscess - endoscopic trans nasal trans sphenoidal approach


Publication History

Article published online:
22 January 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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