A-deno What's Going On!

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Identifier walsh_2019_s1_c4-abstract
Title A-deno What's Going On!
Creator Christine Greer, Salina Teja, Jennifer Danesch, Anna Mathew, Vivek Patel, Kimberly Gokoffski
Subject Headaches
Description A 68 year-old Hispanic female with hypertension, type II diabetes mellitus, panhypopituitarism after pituitary adenoma resection 30 years prior and subsequent radiation therapy presented with decreased vision in the left eye and severe headache. The patient's vision in the left eye declined in the preceding four months until she could no longer see light. She described a constant pressure within her left eye and 10/10 headache for nine months. The headaches were similar to the headaches she experienced prior to her initial tumor resection. She had presented to an outside emergency department several times given these symptoms and was suspected to have a recurrent pituitary adenoma. Recently, she had become somnolent without focal deficits. Her medications included levothyroxine, hydrocortisone and oral hypoglycemics and there had been no recent change. Her labs were notable for profound hyponatremia. Ophthalmic exam was notable for 20/60 and NLP vision, amaurotic pupil, and RAPD OS. Intraocular pressures and cranial nerves III-VII were normal. There was no proptosis or ocular adnexal abnormality or findings on slit lamp exam. The cup-to-disc ratio was 0.4 bilaterally with mild-moderate pallor of the left optic nerve. Visual field of the right eye showed diffuse depression. MRI brain with and without contrast demonstrated a 16x19x24 mm heterogenous sellar, suprasellar lesion contiguous with the left optic nerve. Within the mass, there was a non-enhancing T1 and T2 hypointense components thought to be consistent with cystic changes and calcification. The peripheral margins exhibited; heterogenous nodular enhancement, which extended through the sellar floor to the sphenoid sinus, involving the left optic chiasm and optic nerve. CT head showed sella and clival erosion, no evidence of sinus disease. These findings were believed to be consistent with an invasive pituitary adenoma. The patient was referred for surgical resection at which point a diagnostic procedure was performed.
Date 2019-03
Language eng
Format application/pdf
Source 2019 North American Neuro-Ophthalmology Society Annual Meeting
Relation is Part of NANOS 2019: Frank B. Walsh Session 1
Collection Neuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Holding Institution North American Neuro-Ophthalmology Association. NANOS Executive Office 5841 Cedar Lake Road, Suite 204, Minneapolis, MN 55416
Rights Management Copyright 2019. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright
ARK ark:/87278/s6xt0cjw
Contributor Primary Salina Teja
Contributor Secondary Jennifer Danesch, Anna Mathew, Vivek Patel, Kimberly Gokoffski
Setname ehsl_novel_fbw
ID 1431953
Reference URL https://collections.lib.utah.edu/ark:/87278/s6xt0cjw
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