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118<br />
bigger than 40 years as predictive factors for long<br />
term weight loss ineffectiveness after gastric banding<br />
surgery. Other studies must be conducted to defi<br />
ne, with a higher accuracy, the selection criteria’s<br />
for bariatric surgery.<br />
Key words: gastric banding, IGF-1, morbid<br />
obesity, insulin resistance<br />
Clinical presentati on, treatment, and<br />
outcome in pituitary apoplexy with<br />
intraventricular hemorrhage: case report<br />
Adriana Dediu¹; LigiaTataranu,<br />
Mircea Radu Gorgan<br />
¹PhD Student in Neu<strong>ro</strong>surgery, University of Medicine<br />
and Pharmacy “Ca<strong>ro</strong>l Davila” Bucharest, Faculty of<br />
Medicine, Department of Neu<strong>ro</strong>surgery<br />
Clinic of Neu<strong>ro</strong>surgery, Third Department of<br />
Neu<strong>ro</strong>surgery, Emergency Clinical Hospital Bagdasar-<br />
Arseni, Bucharest<br />
Backg<strong>ro</strong>und<br />
Pituitary tumor apoplexy is a clinical synd<strong>ro</strong>me<br />
characterized by abrupt onset of a severe headache,<br />
nausea, vertigo, meningismus, and/or decreased<br />
level of consciousness.<br />
It is generally consequent to the following: subarachnoid<br />
extravasation of blood and dural irritation,<br />
cranial nerve and hemispheric compression<br />
f<strong>ro</strong>m lateral or superior extention of nec<strong>ro</strong>tic and/or<br />
hemorrhagic material, endocrine abnormalities<br />
f<strong>ro</strong>m acute pituitary dysfunction.<br />
Standard therapy of pituitary apoplexy includes:<br />
high-dose ste<strong>ro</strong>id treatment, which can imp<strong>ro</strong>ve symptoms<br />
in a few days, and surgical decompression via<br />
transsphenoidal <strong>ro</strong>ute, if symptoms are severe or rapidly<br />
p<strong>ro</strong>gressive.<br />
Case report<br />
We report a case of a 56-year old man presented<br />
to <st<strong>ro</strong>ng>medica</st<strong>ro</strong>ng>l attention with sudden severe headache,<br />
nausea, vomiting, dizziness, diplopia and blurring<br />
of vision. Computer tomography and contrast-enhanced<br />
magnetic resonance imaging of the head<br />
p<strong>ro</strong>ved a large sellar tumor with extension to the<br />
sphenoid sinus, suprasellar region and both cavernous<br />
sinuses, predominantly on the right side with<br />
intratumoral hemorrhagic zones and the hemorrhagic<br />
accumulation in the posterior horns of the<br />
lateral ventricles.<br />
The treatment of choice was transsphenoidal app<strong>ro</strong>ach.<br />
REVISTA MEDICALÅ ROMÂNÅ – VOLUMUL LIX, NR. 2, An 2012<br />
Histological examination revealed mixt pituitary<br />
adenoma most of the tumoral fragments were<br />
represented by nec<strong>ro</strong>tic tissue highly suggestive for<br />
pituitary apoplexy.<br />
The outcome was favorableand the patient was<br />
discharged in a good condition, completely oriented,<br />
without other neu<strong>ro</strong>logical signs.<br />
Conclusions<br />
Pituitary apoplexy remains a potentially lifethreatening<br />
disease. Its presentation may vary f<strong>ro</strong>m<br />
relatively benign symptoms to major neu<strong>ro</strong>logical<br />
defi cits and even death. Its early recognition and<br />
treatment are vital.<br />
Tratamentul complex de recuperare al<br />
copilului cu sind<strong>ro</strong>m de neu<strong>ro</strong>n motor<br />
central<br />
Andra Dinu, Valenti na Contanu<br />
Orto-Clinic, Bucureşti<br />
Rezumat<br />
Numărul crescut de cazuri, atât în Romania, cât<br />
şi în lume, varietatea patologiei şi mai ales varietatea<br />
schemelor de tratament motivează pe deplin alegerea<br />
acestei teme ca lucrare ştiinţifi că.<br />
Cuvinte cheie: recuperare <st<strong>ro</strong>ng>medica</st<strong>ro</strong>ng>lă, preşcolar<br />
neu<strong>ro</strong>motor, evaluare elect<strong>ro</strong>miografi că, eligibil<br />
Obiectiv<br />
Lucrarea face o analiză a tehnicilor de recuperare<br />
pentru a determina care este cea mai efi cientă pentru<br />
scopul nostru fi nal, şi anume integrarea copilului cu<br />
leziune de neu<strong>ro</strong>n motor central în şcoală, optimizarea<br />
metodelor de prevenţie a acestor boli şi<br />
efi cientizarea sistemului de sănătate publică. Activitatea<br />
a antrenat un consorţiu multidisciplinar format<br />
din parteneri cu expertiză în domeniul neu<strong>ro</strong>logiei,<br />
ortopediei şi clinicieni cu experienţă<br />
acumulată în p<strong>ro</strong>iecte de cercetare naţionale şi<br />
internaţionale, cu atribuţii specifi ce. Absenţa unor<br />
p<strong>ro</strong>grame de monitorizare şi prevenţie pentru<br />
afecţiunile neu<strong>ro</strong>logice în România şi a unor date<br />
exacte cu privire la modul de integrare al copiilor<br />
cu afecţiuni neu<strong>ro</strong>motorii, impune crearea unui<br />
sistem integrat şi efi cient de monitorizare a pacienţilor<br />
cu defi cit neu<strong>ro</strong>motor, dar eligibili pentru activitatea<br />
şcolară. Sesizând tendinţa de creştere a<br />
afec ţiunilor neu<strong>ro</strong>logice se impune, şi pentru ţara<br />
noastră, aplicarea unor metode de prevenţie la<br />
standarde eu<strong>ro</strong>pene.