Sphenoid sinus aspergilloma in trans-sphenoidal surgery for pituitary adenomas.

Background: Simultaneous appearance of sphenoid sinus aspergilloma and pituitary adenoma is a very rare finding.

Methods: Retrospective analysis of patients with sellar and sphenoid sinus mass lesions who underwent trans-sphenoidal surgery was performed. Demographic data, medical history, predisposing factors, clinical picture, neurological status and radiological findings were reviewed.

Surgical treatment of prolactinomas--our experience.

The dilemma of whether to apply surgical or drug treatment to prolactinomas has been ongoing for the past 30 years. The aim of this study is to compare the early postoperative values of prolactin (PRL) in two groups of patients with prolactinomas: those who underwent primary surgical-treatment, and those who underwent surgery after a dopamine agonist (DA) therapy. We present the results of surgical treatment on a series of 161 patients with prolactinomas.

[Croatian Society of Endocrinology guidelines for the diagnosis and treatment of acromegaly].

The working group of the Croatian Society of Endocrinology met in September 2011 to discuss the diagnostic and therapeutic dilemmas in patients with acromegaly. The group comprised 9 pituitary specialists including endocrinologists, neurosurgeons, and medical biochemistry specialist. After a critical analysis of published scientific papers the group has developed guidelines for the diagnosis and treatment of acromegaly.

Anesthetic management of patients undergoing pituitary surgery.

Pituitary tumors account for more than 10% of all intracranial tumors. They often present with symptoms of hormonal hypersecretion, although they may also cause hypopituitarism. Transsphenoidal pituitary surgery has become a commonly performed neurosurgical procedure, which has certain challenges for the anesthesiologist due to many distinct comorbidities associated with various adenomas.

Accidental finding of an anomalous spinal nerve root during lumbar-disc surgery: a case report and a review of literature.

Anomalies of lumbosacral nerve roots, even though are rare, have been well documented so far in the medical literature. The early diagnosis of these anomalies may be difficult and it is crucial to develop specific methods for depicting them. Preoperative diagnosis of anomalous lumbosacral spinal nerve roots using the magnetic resonance imaging is essential to facilitate thorough surgical planning in order to avoid unnecessary complications for the patient during surgery.

[ISKRA guidelines for antimicrobial prophylaxis in surgery--Croatian National Guidelines].

Summary. The development of the Guidelines for perioperative prophylactic use of antimicrobial agents (further on Guidelines) was initiated by the Interdisciplinary Section for Antibiotic Resistance Control (ISKRA) of the Croatian Ministry of Health and Social Welfare in accordance with the principles of AGREE (Appraisal of Guidelines for Research and Evaluation) methodology which means that the guidelines are the result of a consensus between all involved professional societies. Guidelines were composed in order to improve antibiotic use in surgical professions.

Medical expertise as a historical phenomenon and academic discipline.

Based on secondary literature, a survey of particular forms of medical expertise over history is presented. The state-to-individual interaction in terms of personality and physical integrity protection, health care, etc., was observed.

Reversible "brain atrophy" in patients with Cushing's disease.

During the past 25 years, we came across 60 patients with corticotroph pituitary adenomas and Cushing's disease. Neuroradiological examination showed prominent volume loss of the brain parenchyma, unexpected for the patient's age. This "brain atrophy" appeared to regress after surgical removal of pituitary adenoma and normalization of cortisol level.

Oblique transsphenoethmoidal approach to the cavernous sinus.

Pituitary adenomas frequently invade the cavernous sinus. The standard transsphenoidal approach does not provide satisfactory visualization of the cavernous sinus structures. The transcranial approach has no advantages, and increases the operative trauma and complications.

Centenary of the first trans-sphenoidal surgery of the hypophysis (Hermann Schloffer 1907) and its echoes within Croatian neurosurgical practice.

In this paper we aim to reminisce the role of the Austrian surgeon Hermann Schloffer (1868-1937) as the pioneer of a trans-sphenoidal approach to the pituitary gland. On the 16th of March 1907 he operated a patient with pituitary tumor and published his report in the Wiener Klinische Wochenschrift on 23rd May 1907. This paper is to recall the 100th anniversary of this event.

Sellar region surgery in Croatia in the first half of 20th century.

We reconstructed the historical development of surgical approaches to the pituitary gland, which were used in Croatia in the first half of the 20th century, on the basis of earliest clinical case reports and descriptions of initial surgical attempts. The first published case report on surgical treatment of acromegaly was described, as well as the review of 11 patients with pituitary disease admitted to the Ophthalmology Clinic in Zagreb in the period 1925-1927. The earliest 5 reports on pituitary surgery dating from 1925 were analyzed to reveal the circumstances that led to the development of transsphenoidal approach as a method of choice in Croatia, when this technique was becoming obsolete in other parts of the world.

Incidence of pituitary tumors in the human population of Croatia.

Pituitary tumors are rare tumors (less then 10%) of the central nervous system (CNS), which malignicity depends on their localization, meanwhile, their biological nature is benign. The diameter they have is mostly less then 10 mm (microadenomas), but sometimes could be 10 mm (macroadenomas) to 5 cm and more and then are usually nonfunctional (about 20% of all pituitary tumors). Clinical presence depends on their localisation and hormonal activity.

[Optic nerve injury from the medical expertise point of view].

The optic nerve can be injured directly or indirectly. Direct injury occurs in association with orbital or craniocerebral injury with interruption of anatomical and functional optic nerve integrity. Indirect injuries occur when the force of impact is transmitted to the optic nerve.

[Contemporary surgical treatment of sellar region tumors].

Due to improved diagnostics, and primarily neuroradiological methods, an increased incidence of sellar region tumors is marked, among which the most common are pituitary adenomas. Sellar region tumors cause dysfunctions of the hypothalamo-pituitary axis as well as surrounding neurovascular structures. Despite the development of pharmacological and radiation therapy, surgical treatment is in these cases still a dominant therapeutical method.

[80 years of hypophyseal surgery at the Sestre Milosrdnice Hospital].

Sestre milosrdnice University Hospital has celebrated its 155th anniversary. In this period, it has been the origin of Croatian medical masterminds and a place of numerous pioneer events. After V.