Biomedical subjects

Wai Hoe Ng

Publications and source records attributed to Wai Hoe Ng.

4 recordsLinked to original sources

PubMed2003

Coexistence of aneurysmal subarachnoid haemorrhage and pituitary apoplexy: Case report and review of the literature.

A case of aneurysmal subarachnoid haemorrhage with associated haemorrhagic infarction of a growth hormone secreting pituitary macroadenoma is presented. The subarachnoid haemorrhage was not identifiable on CT, but was apparent on MRI. Angiography revealed a 7mm right posterior communicating aneurysm, a 3mm left A1 segment anterior cerebral aneurysm, and vasospasm. Surgery was performed through a right pterional/subfrontal approach, clipping both aneurysms and debulking the tumour. The left A1 aneurysm was the site of subarachnoid haemorrhage. There was evidence of haemorrhagic infarction of the pituitary tumour. Although rupture of an aneurysm into a pituitary tumour has been previously reported, this is the first case reported of aneurysmal subarachnoid haemorrhage with coexisting pituitary apoplexy where the aneurysm had not bled directly into the pituitary tumour. The literature regarding the association between pituitary tumours and aneurysm is reviewed.

Enzymes↗

PubMed2003

Lymphocytic hypophysitis.

Lymphocytic hypophysitis is a rare but important cause of pituitary hypofunction which predominantly affects young women in the peripartum period. It is believed to be an autoimmune disorder with an association with other autoimmune disorders and expression of anti-pituitary cytosolic and anti-nuclear antibodies. Clinically, it presents most frequently with symptoms and signs attributable to pituitary hypofunction, headache, visual disturbance and amenorrhoea. It is difficult to distinguish lymphocytic hypophysitis from a pituitary adenoma on pre-operative imaging and definitive diagnosis rests on histology which classically demonstrates destruction of anterior pituitary acini by an inflammatory infiltrate rich in plasma cells and T lymphocytes. Surgical management therefore plays a crucial role to obtain a histological diagnosis and to relieve pressure effects on the optic apparatus in patients with visual disturbances.

Adult↗

PubMed2002

Spinal epidural haematoma: MRI-aided diagnosis.

Spinal epidural haematoma is a rare cause of spinal cord compression. It is most commonly attributed to trauma and coagulation disorders. We report a case of a 64 year-old man with thrombocytopaenia who presented with a traumatic epidural haematoma who p resented with right hemiparesis which progressed to complete tetraplegia. MR of the cervical spine showed an epidural collection on the posterior aspect of the cord throughout the cervical spine. The patient underwent C1-C7 laminectomy and decompression. Postoperatively, the patient has improved gradually and has power of grade 3 (Medical Research Council classification of power) in all 4 limbs at 2-month follow-up. MRI is an important modality in the early diagnosis of spinal epidural haematomas and can facilitate emergent decompressive surgery which offers the best chance of neurological improvement.

Decompression, Surgical↗

PubMed2002

Lymphocytic hypophysitis mimicking pituitary macroadenoma.

Lymphocytic hypophysitis is an uncommon disease with a variable presentation and unclear pathophysiology. We present the case of a 30 year old woman who presented with features typical of a pituitary macroadenoma. She underwent a transphenoidal resection of the mass and histopathological examination revealed lymphocytic hypophysitis. This case illustrates the difficulty in differentiating pituitary macroadenoma and lymphocytic hypophysitis and the variable presentations of lymphocytic hypophysitis.

Adenoma↗