A 38-year-old man with pneumococcal meningitis, pneumocephalus, and CSF rhinorrhea was admitted to our hospital. The CSF rhinorrhea had no traumatic or iatrogenic etiology. The patient was treated with meropenem and recovered from meningitis. Axial plain CT showed pneumocephalus (figure 1, A and B), but no skull defects. Three-dimensional CT revealed defects of the posterior walls of the spheno...

A 68-year-old woman developed Cushingoid features three months prior to admission. She was found to have a markedly elevated plasma ACTH-cortisol level. Magnetic resonance imaging (MRI) revealed a mass in the left sphenoidal sinus, which had become enlarged to a point where it could not be removed by transsphenoidal surgery. We decided to proceed with radiation therapy to shrink the tumor. Howe...

The treatment of functioning pituitary adenoma (FPA) must achieve endocrinological remission as well as tumor size reduction. The first-line treatment of FPA except prolactinoma is transsphenoidal surgery (TSS). Medical treatments and/or radiation will be applied as adjuvant therapies succeeding to TSS. In patients with prolactinoma, dopamine agonists, especially cabergoline, are quite efficien...

BACKGROUND Transsphenoidal surgery (TSS) is the treatment of choice for Cushing's disease (CD). Postoperative hypercortisolemia mandates further therapy. OBJECTIVE The aim of the study was to characterize patients without immediate postoperative remission who have a delayed decrease to normal or low cortisol levels without further therapy. DESIGN AND SETTING A retrospective case series was ...

In our previous issue the method of diagnosing the existence of infective sphenoidal sinusitis by means of the exploratory suction syringe was described, affording as it does the only criterion of the presence of the affection short of actual inspection of the discharge escaping from the sphenoidal sinus ostium, a very rare event compared with the relative frequency of the disease. Further, the...

Diagnostically as well as therapeutically, meningiomas of the so-called sphenoidal ridge present several difficulties. We therefore make a few remarks concerning the diagnostic aspects of this problem. In another paper we hope to deal with the operative treatment. In a female patient recently seen, after long deliberation, we established a diagnosis of a meningioma of the innermost part of the ...

Staphylococcal toxic shock syndrome (TSS) was originally described in menstruating women and linked to TSS toxin 1 (TSST-1)-producing Staphylococcus aureus. Using UK national surveillance data, we ascertained clinical, molecular and superantigenic characteristics of TSS cases. Average annual TSS incidence was 0.07/100,000 population. Patients with nonmenstrual TSS were younger than those with m...