Sudden Sensorineural Hearing Loss after Pituitary Adenoma Resection-A Case Series with Literature Review

Objective Complications after transsphenoidal surgery for pituitary adenoma have been well documented in the literatures,but the occurrence of delved sudden sensorineural hearing loss(SNHL)after pituitary adenoma resection is extremely rare.In this study three cases who developed sudden SNHL 3 to 7 days after pituitary adenoma surgery without experiencing cerebrospinal fluid leak or meningitis were presented,and the possible causes of SNHL were discussed.Methods Three cases with sudden hearing loss after transsphenoidal surgery for pituitary adenoma were reviewed.The past medical history,onset of sudden hearing loss,accompanying symptoms such as headache,tinnitus,dizziness and aural fullness,and the post-operative MRI images,therapy and hearing results were reported.Results Three cases developed profound sudden SNHL on the 3rd to 7th post-operative day,all accompanied by prior headache,tinnitus and dizziness.One patient developed episodic vertigo,ear fullness accompanying with fluctuating hearing loss in the first post-operative month.Two patients had past medical history of arteriosclerosis and coronary heart disease or cerebral infarction.Two of three demonstrated obstructive hydrocephalus on MRI on the first post-operative day.Under treatment with prednisone orally,dexamethasone intratympanic mjection,neurotrophic and vasodilatation drugs for 3 to 8 months,hearing of all three improved partially.Obstructive hydrocephalus and ischemia might be responsible for the hearing loss.Conclusion Post-operative obstructive hydrocephalus and ischemia of labyrinthine arteries might lead to the delayed SNHL after transsphenoidal surgery for pituitary adenoma.

Spontaneous pineal apoplexy in a pineal parenchymal tumor of intermediate differentiation

Pineal apoplexy is a rare clinical presentation of pineal parenchymal tumors. We report the curative treatment of a case of pineal parenchymal tumor of intermediate differentiation with spontaneous apoplectic hemorrhage. This case is shown through computed tomography and magnetic resonance imaging of the brain, and is confirmed via histopathological studies. Recurrent upward gaze paresis was observed after the stereotactic biopsy. The paresis required an expeditious tumor resection. The mechanism of the pineal apoplectic hemorrhage remains unclear although it has been observed in different pineal region lesions. Clinical and radiological evidence of the cure 5 years post-surgery is available.

Primary Meningeal Melanocytoma Located in Foramen Magnum:a Case Report and Review of the Literatures

LIMAS and Tio1 proposed the term meningeal melanocytoma first time in 1972 to describe a primary melanotic tumor of the leptomeninges with prolonged clinical course and benign histology.Meningeal melanocytoma of the central nervous system is rare and benign primary meningeal melanocytoma (PMM) is more exceptional,and also less usual than the malignant types.2 This rare tumor falls under the subclassification of primary melanocytic lesions in the World Health Organization's classification of central nervous system tumors.3 PMM located in the foramen magnum region is an unusual cause of bulbus medullae and fourth ventricle compression.Here we report a 48-year-old man with a PMM which is located in the foramen magnum inducing supratentorial obstructive hydrocephalus.