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Biomedical subjects

Walter J Molofsky

Publications and source records attributed to Walter J Molofsky.

2 recordsLinked to original sources

Managing stroke in children.

The incidence of stroke in the pediatric population is estimated at between 2 and 3 per 100,000. Strokes are divided into ischemic or hemmorhagic categories, depending on whether the primary cause is obstruction or bleeding into the brain. Strokes may present with acute, recurrent, or evolving neurological deficits. There is a long and varied list of causes of stroke in children. The major causes of ischemic stroke are cardiac abnormalities and coagulation disorders. Cerebrovascular malformations account for the majority of hemmorhaghic strokes. The workup is guided by the initial history and imaging studies. Treatment is dependent on the specific risk factors identified, and outcome is dependent on the location and extent of the initial insult.

Adult↗

Hemorrhagic pituitary apoplexy in an 18 year-old male presenting as non-ketotic hyperglycemic coma (NKHC).

Pituitary apoplexy is an acute clinical event usually caused by hemorrhage or infarction in a pituitary adenoma. We report the unusual case of hemorrhagic pituitary apoplexy in an 18 year-old male with previously undiagnosed type 2 diabetes mellitus who presented with unexplained hyperglycemia (glucose 49.2 mmol/l [887 mg/dl]) and obtundation and in whom an initial diagnosis of non-ketotic hyperglycemic coma (NKHC) was made. MRI revealed a heterogeneous mass arising from an expanded sella turcica into the suprasellar cistern. Despite well-controlled glucose levels on continuous insulin infusion, dexamethasone, and initiation of bromoergocriptine (parlodel) therapy, the patient's vision and pupillary responses deteriorated acutely. Following emergency transphenoidal surgery, the patient's vision and mental status improved. Data confirmed preoperative panhypopituitarism; serum prolactin was 396 ng/ml (microg/l). Immunostudies demonstrated tumoral labeling for prolactin, but not for ACTH, GH, TSH, LH, FSH, or P53.

Adenoma↗