Our functional evaluation of AIP mutations is consistent with a tumor-suppressor role for AIP and its involvement in familial acromegaly. The abnormal expression and subcellular localization of AIP in sporadic pituitary adenomas indicate deranged regulation of this protein during tumorigenesis.

In the course of 4 years, the size of the incidentalomas increased in 40% of 42 patients and became symptomatic in 20%. During the 5-year follow up, pituitary apoplexy developed in 9.5%. These findings may justify early intervention, especially in young individuals with incidentally found macroadenoma.

The syndrome of the sinking skin flap (SSSF) has been described as one of the causes of neurological deficits after decompressive craniectomy We report a case of a 57-year-old woman with SSSF. Two years earlier, this patient, with no neurological deficits, underwent removal of the bone flap during treatment of an epidural abscess due to wound infection after a clipping operation for a ruptured aneurysm. The patient, who subsequently developed a sinking skin flap, gradually presented with gait disturbance and poor activity around 1 year before she came to our facility. On admission, neurological examination showed left hemiparesis and mild confusion. Cranioplasty with titanium mesh plate was performed. The cerebral blood flow (CBF) value in CT perfusion imaging in the symptomatic hemisphere increased from 23 to 31 cm3/100 g/min, and the value in the contralateral side increased from 37 to 41 cm3/100 g/min after cranioplasty. CT perfusion imaging after cranioplasty revealed the improvement of cerebral blood flow not only on the symptomatic side but also on the contralateral side. The patient recovered well and was discharged without hemiparesis and confusion 2 weeks after cranioplasty. As far as we know, this is the first reported case of SSSF examined with CT perfusion imaging before and after cranioplasty.

Abstract.The pituitary function of patients with Rathke's cleft cyst before and after surgery was investigated to clarify the significance of surgery and operative indications.The authors have treated 19