35 yr old male wid left sided hearing loss , headache n multiple episodes of vomiting.np other complaint..ct brain report s/o pituitary adenoma.kindly suggest further management?

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Why patient have unilateral hearing loss? patient gave any history of tinnitus ? may be it require evaluation of CP angle region also.

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Advised surgery.

adv surgery

we need to consider first if it is a microadenoma/ macroadenoma. what structures are being compressed? if symptoms of compression present, we can gv bromocriptine or cabergoline. if symptoms persist, transsphenoidal surgery. ct pics suggestive of macroadenoma. size may be decreased using cabergoline, bromocriptine. s.prolactin levels to be done. can be operated.

ok doc
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shunt is not necessary, direct transphonoidal excision

ok sir
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That lesion in CT dosent look like a pituitary adenoma And hearing loss is not a symptom of pituitary adenoma Lesion in more on right side There is perilesional edema Kindly get an MRI brain plain plus contrast That will direct the further management

kumaryasava 15mlafter meal tapyadiloha and sutsekhar in morning and evening for a month. may change the picture
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Is it macro adenoma or Micro Adenoma ??? Symptoms suggest raised ICT. After stabilisation of the vitals, Surgical excision of the pituitary Adenoma remains the treatment. You are the better judge as a Neuro Surgeon.

You should have uploaded the CT
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If pituitary tumor over producing the hormone thn drugs like bromocrptin and cabergolin are used to treat tumor that secreat prolactin...and octreotide can be used to treat tumor that makes growth hormone....

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As primary treatment goals Reduce hormone secretions. Decrease tumour size to improve symptoms of mass effect ,correcting hormone deficiencies .

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This is a case of pitutary adenoma with symptoms suggestive of increased Intracranial tension. Depending on the tumor whether it is benign or malignant, excision of the tumor and send it for biopsy for further management of tumor like radiotherapy and chemotherapy as situation needs. Before surgery a stent may be needed. Final decision is yours as a neurosurgeon

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