Significant increases of pituitary tumors and resections from 1993 to 2011

OBJECTIVE Adult-onset hydrocephalus is not commonly discussed in the literature, especially regarding its demographic distribution. In contrast to pediatric hydrocephalus, which is related to a primary CSF pathway defect, its development in adults is often secondary to other pathologies. In this study, the authors investigated the epidemiology of adult-onset hydrocephalus as it pertains to different etiologies and in reference to age, sex, and race distributions. METHODS The authors retrospectively reviewed the clinical notes of 2001 patients with adult-onset hydrocephalus who presented to Louisiana State University Health Sciences Center within a 25-year span. Significant differences between the groups were analyzed by a chi-square test; p < 0.05 was considered significant. RESULTS The overall mean (± SEM) incidence of adult hydrocephalus in this population was 77 ± 30 per year, with a significant increase in incidence in the past decade (55 ± 3 [1990–2003] vs 102 ± 6 [2004–2015]; p < 0.0001). Hydrocephalus in a majority of the patients had a vascular etiology (45.5%) or was a result of a tumor (30.2%). The incidence of hydrocephalus in different age groups varied according to various pathologies. The incidence was significantly higher in males with normal-pressure hydrocephalus (p = 0.03) or head injury (p = 0.01) and higher in females with pseudotumor cerebri (p < 0.0001). In addition, the overall incidence of hydrocephalus was significantly higher in Caucasian patients (p = 0.0002) than in those of any other race. CONCLUSIONS Knowledge of the demographic variations in adult-onset hydrocephalus is helpful in achieving better risk stratification and better managing the disease in patients. For general applicability, these results should be validated in a large-scale meta-analysis based on a national population database.

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“…Among intracranial tumors, the incidence of pituitary tumors is 10%-15%. 26 Giant pituitary tumors can cause hydrocephalus.…”

Section: Tumorsmentioning

confidence: 99%

Epidemiology of adult-onset hydrocephalus: institutional experience with 2001 patients

Bir

Patra

Maiti

et al. 2016

FOC

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“…Opposed to the soaring rises in cost seen in the treatment of some disease processes,30 the cost of acute ischemic stroke admission treated with MT remained relatively stable over the 5 year study period. This is reassuring but we should highlight that our analysis does not reflect the true societal cost 31–33.…”

Section: Discussionmentioning

confidence: 96%

Trends in mortality following mechanical thrombectomy for the treatment of acute ischemic stroke in the USA

Villwock

Padalino

Deshaies

2015

J NeuroIntervent Surg

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Utilization of MT represents a small percentage of stroke cases, although the trend is increasing. Mortality following MT has been showing a steady decline over the past 5 years. This may be a result of a learning curve, improved patient selection, and/or device improvements. Randomized trials remain essential to evaluate the potential benefit of endovascular devices and identify the most appropriate patients.

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“…9 Transsphenoidal surgery is the main line of treatment for many kinds of pituitary adenoma. 1 Medical management like Dopamine agonist and radiotherapy are other modalities of its treatment.…”

Section: Discussionmentioning

confidence: 99%

Pituitary Adenoma Surgery: Retrospective Analysis of My Personal Experience

Shrestha

Rajbhandari

2016

Nep J Neurosci

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Pituitary tumors are one of the common brain tumors after gliomas, meningieomas and acoustic schwaanomas. It is commonly encountered in Nepal also as in other countries.Retrospective case series analytical study was done. The cases of pituitary adenoma from 2009 till 2015 were included. Types of pituitary adenoma, surgical technique, postoperative morbidities, mortalities and outcome were analyzed.Total 21 cases of pituitary adenoma were operated. All the cases were diagnosed by MRI, plain and contrast. In addition, thorough hormonal evaluation was done. All the cases were operated via transnasal transsphenoidal (TSS) approach. Microscope was used in all the cases whereas endoscope was used in selected cases. Preoperative lumbar puncture and CSF drain was not done in any case.Postoperative transient nasal CSF leak and diabetes insipidus were the most common surgery related morbidities in almost 50% cases which were totally cured with time. All the patients became asymptomatic and got better after surgery. Postoperative mortality and long term morbidity were nil. Recurrence was noted in one case after 3 years of surgery.Pituitary tumor surgery is safe and rewarding provided it is done carefully with skilled hands. TSS is a good approach with minimal postoperative complications. Better to have both microscope and endoscope for TSS.

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Significant increases of pituitary tumors and resections from 1993 to 2011

Abstract: Pituitary tumor diagnoses and resections have grown significantly over the past 20 years. Transsphenoidal surgical resection among this patient population has increased significantly, whereas transfrontal resections have decreased.

Cited by 43 publications

References 17 publications

Epidemiology of adult-onset hydrocephalus: institutional experience with 2001 patients

Epidemiology of adult-onset hydrocephalus: institutional experience with 2001 patients

Trends in mortality following mechanical thrombectomy for the treatment of acute ischemic stroke in the USA

Pituitary Adenoma Surgery: Retrospective Analysis of My Personal Experience

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