Adenoma Hipofisis pada Penyakit tumor otak
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1. Myxedema coma is a life-threatening complication of severe hypothyroidism where an acute illness triggers altered mental status and hypothermia. It results from decreased thyroid hormone levels leading to reduced thermogenesis, cardiac function, respiratory drive, and brain function.
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1. The adrenal glands sit above the kidneys and have two parts - the inner adrenal medulla and outer adrenal cortex.
2. Primary hyperaldosteronism (Conn's syndrome) is caused by excessive aldosterone and results in hypertension. It can be treated by surgery or medication.
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The document summarizes key topics in endocrinology, including disorders of the thyroid, parathyroid, and adrenal glands. It discusses hypothyroidism and its causes, signs, symptoms, and treatment with levothyroxine replacement. It also covers thyrotoxicosis, hyperparathyroidism, Cushing's syndrome, and disorders of the adrenal cortex that can cause hormone deficiencies or excesses. The quiz at the end reviews topics like Cushing's syndrome and autoimmune destruction of pancreatic beta cells in type 1 diabetes.
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This patient has hypokalemia with metabolic alkalosis. The combination of hypokalemia and hypertension suggests hyperaldosteronism, likely primary hyperaldosteronism (Conn syndrome). Aldosterone causes increased sodium reabsorption and potassium secretion in the distal tubule of the kidney, resulting in hypokalemia and metabolic alkalosis. Further workup would include plasma aldosterone and renin levels.
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This document summarizes different types of intracranial hemorrhages. It classifies hemorrhages based on location as either intra-axial within the brain parenchyma, or extra-axial outside the brain. Common intra-axial hemorrhages include those in the basal ganglia, thalamus, cerebellum, and pons caused by hypertension. Extra-axial hemorrhages include epidural, subdural, and subarachnoid hemorrhages. Clinical features, management, and prognosis are described for different hemorrhage types. Surgical evacuation or medical management are used depending on location and size of the bleed.
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This document provides information on the adrenal gland, including its embryology, anatomy, physiology, and various disorders. It discusses topics such as adrenal cortex and medulla disorders, adrenal tumors, adrenal insufficiency, and adrenal surgery. Specific conditions covered include Cushing's syndrome, pheochromocytoma, congenital adrenal hyperplasia, hyperaldosteronism, adrenocortical carcinoma, and adrenal incidentaloma. Diagnostic tests and treatment options are provided for each condition. Adrenal surgery techniques such as open and laparoscopic approaches are also summarized.
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The document discusses adrenal gland tumors and their management. It begins with the anatomy and physiology of the adrenal glands and outlines the classification of adrenal tumors. It then discusses specific tumor types like adrenocortical adenoma, adrenocortical carcinoma, pheochromocytoma, neuroblastoma, and ganglioneuroma. For each tumor, it covers clinical features, diagnosis, and management strategies including surgery, medication, and follow up. Surgical resection is the primary treatment for most benign functioning and non-functioning tumors, while malignant tumors may also require chemotherapy or radiation.
endocrine emergencies.pptx
1. Myxedema coma is a life-threatening complication of severe hypothyroidism where an acute illness triggers altered mental status and hypothermia. It results from decreased thyroid hormone levels leading to reduced thermogenesis, cardiac function, respiratory drive, and brain function.
2. Key features include hypothermia, altered mental status, bradycardia, respiratory issues, hyponatremia, and hypoglycemia. Diagnosis is based on clinical features and laboratory tests showing elevated TSH and low free T4.
3. Treatment involves thyroid hormone replacement with intravenous levothyroxine and/or liothyronine, glucocorticoids, supportive care, and treating any underlying
adrenal gland hhhhhhhhhhhhhhhhhhhhhh.pdf
1. The adrenal glands sit above the kidneys and have two parts - the inner adrenal medulla and outer adrenal cortex.
2. Primary hyperaldosteronism (Conn's syndrome) is caused by excessive aldosterone and results in hypertension. It can be treated by surgery or medication.
3. Cushing's syndrome is excessive cortisol and can be ACTH-dependent or independent. It is usually diagnosed by hormone tests and treated by surgery, medication, or radiation depending on the cause.
2 endocrinology contd
The document summarizes key topics in endocrinology, including disorders of the thyroid, parathyroid, and adrenal glands. It discusses hypothyroidism and its causes, signs, symptoms, and treatment with levothyroxine replacement. It also covers thyrotoxicosis, hyperparathyroidism, Cushing's syndrome, and disorders of the adrenal cortex that can cause hormone deficiencies or excesses. The quiz at the end reviews topics like Cushing's syndrome and autoimmune destruction of pancreatic beta cells in type 1 diabetes.
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This document discusses pituitary tumors, including their:
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- Parts including the adenohypophysis and neurohypophysis which develop from different embryological origins.
- Relations to surrounding structures like the optic chiasm.
- Physiology in secreting hormones like growth hormone, prolactin, ACTH.
- Classification into functional vs non-functional subtypes.
- Management involves medical treatment using drugs, surgical resection via transsphenoidal surgery, and radiation therapy using techniques like radiosurgery or proton beam therapy.
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1) The document discusses hypertensive crisis and defines hypertensive emergency, urgency, and malignant hypertension.
2) It provides diagnostic criteria and risk factors for hypertensive crisis and describes potential target organ damage.
3) Treatment options for hypertensive crisis are discussed, including intravenous drugs like labetalol, nicardipine, clevidipine, hydralazine, nitroglycerin, and sodium nitroprusside. Goals of treatment and monitoring are outlined.Intracerebral hemorrhage
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Pituitary april-12 د فائزة
- The most common cause of hyperpituitarism is anterior lobe pituitary adenoma. Pituitary adenomas can be macroadenomas (>1 cm) or microadenomas and can be functioning or nonfunctioning.
- Functioning adenomas are associated with distinct endocrine signs and symptoms depending on the hormone secreted, such as lactotroph adenomas secreting prolactin causing amenorrhea and galactorrhea. Somatotroph adenomas secreting GH cause gigantism or acromegaly. Corticotroph adenomas secreting ACTH cause Cushing syndrome.
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This document discusses adrenal insufficiency and its causes, signs and symptoms, diagnostic evaluation, and treatment. It covers primary, secondary, and tertiary adrenal insufficiency. Diagnostic tests include morning cortisol levels and cosyntropin stimulation testing. Treatment involves glucocorticoid and mineralocorticoid replacement. Complications like adrenal crisis are also addressed.
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This document discusses pituitary adenomas, benign tumors of the pituitary gland. It covers the anatomy and hormones of the pituitary gland. Pituitary adenomas can be secreting or non-secreting, and cause various clinical effects depending on the hormone secreted including visual field defects. Diagnosis involves endocrine and imaging evaluations. Treatment depends on the size and type of tumor, and may include medication, surgery, and radiation therapy. Long term monitoring of patients is important after treatment.
K - 29 EMB BDH ; pituitaryadenoma.pptx
This document discusses pituitary adenomas, which are benign tumors of the pituitary gland. It covers the anatomy and hormones of the pituitary gland. Pituitary adenomas can cause hormonal imbalances or mass effects that compress surrounding structures. Common neurological and ophthalmological manifestations include visual field defects, headaches, and eye movement disorders. Treatment involves medical therapy, surgery, or radiotherapy depending on the size and type of tumor. Long term monitoring is needed to check for recurrence or regrowth. A multidisciplinary approach between endocrinologists, neurosurgeons, and ophthalmologists is important for managing these tumors.
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Hypopituitarism is a condition caused by insufficient production of hormones by the pituitary gland. The pituitary gland is divided into the anterior and posterior pituitary. The anterior pituitary contains cell types that synthesize important hormones such as growth hormone, prolactin, ACTH, TSH, and gonadotropins. Hypopituitarism can be caused by developmental defects, tumors, vascular issues, trauma, infections, or autoimmune disorders. Common symptoms depend on which hormones are deficient but may include short stature, weight changes, hypoglycemia, fatigue, and sexual dysfunction. Several genetic syndromes like septo-optic dysplasia, Prader-Willi syndrome, and Kallman syndrome can also cause
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Cushing's syndrome is caused by excessive cortisol production and can be due to exogenous sources, a pituitary adenoma, or an adrenal tumor. The most common signs are truncal obesity, high blood pressure, and diabetes. Diagnosis involves tests that check for failure to suppress cortisol levels with dexamethasone. Determining the cause involves additional tests like ACTH levels and imaging. Treatment depends on the underlying cause but may include surgery, medication, or adrenalectomy. Addison's disease is a rare condition of adrenal insufficiency that can result in pigmentation, low blood pressure, and hypoglycemia. Pheochromocytoma is a tumor of the adrenal medulla that secretes catechol
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The document summarizes Sheehan's syndrome, which is pituitary hypofunction resulting from infarction and necrosis of the enlarged pituitary gland during pregnancy, usually due to postpartum hemorrhage. It describes the anatomy and vascularization of the pituitary gland, risk factors for Sheehan's syndrome such as massive PPH and small sella turcica. Clinical manifestations include deficiencies of anterior pituitary hormones. Diagnosis involves endocrine testing and MRI showing an empty sella. Management involves hormone replacement therapy. Prevention relies on proper management of PPH.
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1. Gastrointestinal bleeding is a common presenting problem in the emergency room, with upper GI bleeding having an annual incidence of approximately 47 per 100,000 people.
2. The main causes of upper GI bleeding include peptic ulcers, esophageal varices, gastritis, and esophagitis.
3. The initial priorities in management are resuscitation through fluid resuscitation and blood transfusion if needed, followed by endoscopy to determine the source of bleeding and provide endoscopic therapy if active bleeding is detected.
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The purpose of this webcast is to:
Discuss and demonstrate the approaches with array and NGS genotyping methods for star allele calling to prep for downstream analysis.
Following genotyping, explore alternative tertiary workflow concepts in VarSeq to handle PGx reporting.
Moreover, we will include insights users will need to consider when validating their PGx workflow for all possible star alleles and options you have for automating your PGx analysis for large number of samples. Please join us for a session dedicated to the application of star allele genotyping and subsequent PGx workflows in our VarSeq software.
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- Relations to surrounding structures like the optic chiasm.
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Cushing's syndrome is caused by excessive cortisol levels due to hyperfunction of the adrenal glands or pituitary gland. It results in central obesity, mood changes, high blood pressure, and other signs and symptoms. The dexamethasone suppression test is used to diagnose Cushing's syndrome by showing that cortisol levels are not suppressed as expected. Addison's disease is caused by primary adrenal insufficiency leading to cortisol and aldosterone deficiencies. Patients present with weakness, low blood pressure, and hyperpigmentation. The short Synacthen test shows no increase in cortisol levels in response to synthetic ACTH stimulation. Both conditions require lifelong hormone replacement therapy and treatment of underlying causes.
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1) The document discusses hypertensive crisis and defines hypertensive emergency, urgency, and malignant hypertension.
2) It provides diagnostic criteria and risk factors for hypertensive crisis and describes potential target organ damage.
3) Treatment options for hypertensive crisis are discussed, including intravenous drugs like labetalol, nicardipine, clevidipine, hydralazine, nitroglycerin, and sodium nitroprusside. Goals of treatment and monitoring are outlined.Intracerebral hemorrhage
Intracerebral hemorrhage is more common in Asian countries and incidence increases with age. It has a high mortality rate, especially when located in the brainstem. Clinical presentation includes altered mental status, headache, nausea and focal neurological deficits depending on the location of bleeding in the brain. CT scan is used to diagnose and determine the size and location of hemorrhage. Treatment focuses on controlling blood pressure, reducing ICP and treating the underlying cause.
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- The most common cause of hyperpituitarism is anterior lobe pituitary adenoma. Pituitary adenomas can be macroadenomas (>1 cm) or microadenomas and can be functioning or nonfunctioning.
- Functioning adenomas are associated with distinct endocrine signs and symptoms depending on the hormone secreted, such as lactotroph adenomas secreting prolactin causing amenorrhea and galactorrhea. Somatotroph adenomas secreting GH cause gigantism or acromegaly. Corticotroph adenomas secreting ACTH cause Cushing syndrome.
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This document discusses adrenal insufficiency and its causes, signs and symptoms, diagnostic evaluation, and treatment. It covers primary, secondary, and tertiary adrenal insufficiency. Diagnostic tests include morning cortisol levels and cosyntropin stimulation testing. Treatment involves glucocorticoid and mineralocorticoid replacement. Complications like adrenal crisis are also addressed.
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This document discusses pituitary adenomas, benign tumors of the pituitary gland. It covers the anatomy and hormones of the pituitary gland. Pituitary adenomas can be secreting or non-secreting, and cause various clinical effects depending on the hormone secreted including visual field defects. Diagnosis involves endocrine and imaging evaluations. Treatment depends on the size and type of tumor, and may include medication, surgery, and radiation therapy. Long term monitoring of patients is important after treatment.
K - 29 EMB BDH ; pituitaryadenoma.pptx
This document discusses pituitary adenomas, which are benign tumors of the pituitary gland. It covers the anatomy and hormones of the pituitary gland. Pituitary adenomas can cause hormonal imbalances or mass effects that compress surrounding structures. Common neurological and ophthalmological manifestations include visual field defects, headaches, and eye movement disorders. Treatment involves medical therapy, surgery, or radiotherapy depending on the size and type of tumor. Long term monitoring is needed to check for recurrence or regrowth. A multidisciplinary approach between endocrinologists, neurosurgeons, and ophthalmologists is important for managing these tumors.
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Hypopituitarism is a condition caused by insufficient production of hormones by the pituitary gland. The pituitary gland is divided into the anterior and posterior pituitary. The anterior pituitary contains cell types that synthesize important hormones such as growth hormone, prolactin, ACTH, TSH, and gonadotropins. Hypopituitarism can be caused by developmental defects, tumors, vascular issues, trauma, infections, or autoimmune disorders. Common symptoms depend on which hormones are deficient but may include short stature, weight changes, hypoglycemia, fatigue, and sexual dysfunction. Several genetic syndromes like septo-optic dysplasia, Prader-Willi syndrome, and Kallman syndrome can also cause
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This document discusses the anesthetic management of patients with pheochromocytoma. It begins by covering the physiology and pathophysiology of catecholamine-producing tumors. It then discusses the clinical presentation of pheochromocytoma, including signs, symptoms, diagnosis, and management - with a focus on preoperative preparation and management. Key aspects of preoperative preparation include controlling blood pressure through alpha and beta blockade, fluid administration, and reversing metabolic disturbances, in order to optimize patient hemodynamics and safety during tumor resection.
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Cushing's syndrome is caused by excessive cortisol production and can be due to exogenous sources, a pituitary adenoma, or an adrenal tumor. The most common signs are truncal obesity, high blood pressure, and diabetes. Diagnosis involves tests that check for failure to suppress cortisol levels with dexamethasone. Determining the cause involves additional tests like ACTH levels and imaging. Treatment depends on the underlying cause but may include surgery, medication, or adrenalectomy. Addison's disease is a rare condition of adrenal insufficiency that can result in pigmentation, low blood pressure, and hypoglycemia. Pheochromocytoma is a tumor of the adrenal medulla that secretes catechol
Sheehan's syndrome
The document summarizes Sheehan's syndrome, which is pituitary hypofunction resulting from infarction and necrosis of the enlarged pituitary gland during pregnancy, usually due to postpartum hemorrhage. It describes the anatomy and vascularization of the pituitary gland, risk factors for Sheehan's syndrome such as massive PPH and small sella turcica. Clinical manifestations include deficiencies of anterior pituitary hormones. Diagnosis involves endocrine testing and MRI showing an empty sella. Management involves hormone replacement therapy. Prevention relies on proper management of PPH.
UGI Bleed
1. Gastrointestinal bleeding is a common presenting problem in the emergency room, with upper GI bleeding having an annual incidence of approximately 47 per 100,000 people.
2. The main causes of upper GI bleeding include peptic ulcers, esophageal varices, gastritis, and esophagitis.
3. The initial priorities in management are resuscitation through fluid resuscitation and blood transfusion if needed, followed by endoscopy to determine the source of bleeding and provide endoscopic therapy if active bleeding is detected.
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The reference for this presentation is Sleisenger and Fordtran's Gastrointestinal and Liver Disease Textbook ( 11th edition ).
Giloy in Ayurveda - Classical Categorization and Synonyms
Giloy, also known as Guduchi or Amrita in classical Ayurvedic texts, is a revered herb renowned for its myriad health benefits. It is categorized as a Rasayana, meaning it has rejuvenating properties that enhance vitality and longevity. Giloy is celebrated for its ability to boost the immune system, detoxify the body, and promote overall wellness. Its anti-inflammatory, antipyretic, and antioxidant properties make it a staple in managing conditions like fever, diabetes, and stress. The versatility and efficacy of Giloy in supporting health naturally highlight its importance in Ayurveda. At Planet Ayurveda, we provide a comprehensive range of health services and 100% herbal supplements that harness the power of natural ingredients like Giloy. Our products are globally available and affordable, ensuring that everyone can benefit from the ancient wisdom of Ayurveda. If you or your loved ones are dealing with health issues, contact Planet Ayurveda at 01725214040 to book an online video consultation with our professional doctors. Let us help you achieve optimal health and wellness naturally.
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Brain specific drug delivery.pptx -Mpharm
BBB and BCF
control the entry of compounds into the brain and
regulate brain homeostasis.
restricts access to brain cells of blood–borne compounds and
facilitates nutrients essential for normal metabolism to reach brain cells
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Selective α1-Blocker.pptx
Selective alpha1 blockers are Prazosin, Terazosin, Doxazosin, Tamsulosin and Silodosin majorly used to treat BPH, also hypertension, PTSD, Raynaud's phenomenon, CHF
biomechanics of running. Dr.dhwani.pptx
The biomechanics of running involves the study of the mechanical principles underlying running movements. It includes the analysis of the running gait cycle, which consists of the stance phase (foot contact to push-off) and the swing phase (foot lift-off to next contact). Key aspects include kinematics (joint angles and movements, stride length and frequency) and kinetics (forces involved in running, including ground reaction and muscle forces). Understanding these factors helps in improving running performance, optimizing technique, and preventing injuries.
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdf
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga
GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort. Recently uploaded (20)
Tele Optometry (kunj'sppt) / Basics of tele optometry.
Tele Optometry (kunj'sppt) / Basics of tele optometry.
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14...
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14...
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acne vulgaris -Mpharm (2nd semester) Cosmetics and cosmeceuticals
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Nano-gold for Cancer Therapy chemistry investigatory project
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Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...
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Spontaneous Bacterial Peritonitis - Pathogenesis , Clinical Features & Manage...
Spontaneous Bacterial Peritonitis - Pathogenesis , Clinical Features & Manage...
Giloy in Ayurveda - Classical Categorization and Synonyms
Giloy in Ayurveda - Classical Categorization and Synonyms
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Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdf
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdf
Adenoma Hipofisis pada Penyakit tumor otak
- 2. • most are benign adenomas arising from the anterior pituitary (adenohypophysis) • presentation (p. 740): most common: symptoms from excess hormonal secretion (includes: hyperprolactinemia, Cushing’s syndrome, acromegaly…), mass effect (most commonly: bitemporal hemianopsia from compression of optic chiasm, hypopituitarism from mass effect), H/A, incidental finding, or infrequently with pituitary apoplexy (p. 741) • work-up for a newly diagnosed intrasellar lesion: see ▶ Table 44.1 • prolactinoma is the only type for which medical therapy (DA agonists) may be the primary treatment in certain cases (p. 759). For other tumor types, options primarily consist of surgery (transsphenoidal or transcranial), or XRT • post-op concerns include: diabetes insipidus, adrenal insufficiency, CSF leak
- 3. • anterior pituitary gland is perfused by its portal venous system, which passes down the hypophyseal stalk. This unusual vascular supply likely contributes to frequency of pituitary apoplexy. • Sindroma perburukan klinis yang mendadak • syndrome caused by the rapid enlargement of a pituitary adenoma because of hemorrhage or infarction • usually evolving in hours, and include headache, vomiting, visual disturbance, ophthalmoplegia, and altered consciousness • changes in intracranial pressure associated with head injuries, repetitive coughing, and procedures such as lumbar puncture, spinal anesthesia, myelography, and angiography, or after radiation, which may damage blood vessel integrity and impair blood supply
- 4. • A well-described theory is that with rapid growth, the tumor outstrips its blood supply, resulting in ischemic necrosis and then hemorrhage • intrinsic vasculopathy yang disebabkan oleh ischemic sehingga terjadi infarction and haemorrhage • supply darah berasal dari superior dan inferior hypophysial artery • MOdalitas MRI • CT scan • Lateral Cranial X Ray • The two pillars of management of pituitary apoplexy have been transsphenoidal decompression and immediate institution of high-dose corticosteroid replacement therapy
- 5. • Classically, pituitary tumors are divided into functional (or secreting), and non- functional (AKA • endocrine-inactive, which are either nonsecretory or else secrete products such as gonadotropin • that do not cause endocrinologic symptoms). • 48% prolactin, 10% GH, 6% ACTH, 1% TSH • Prolactin can cause amenorrhea-galactorrhea • hypothalamic involvement may produce • a) hypotension • b) thermal dysautoregulation • c) cardiac dysrhythmias • d) respiratory pattern disturbances • e) diabetes insipidus • f) altered mental status: lethargy, stupor, or coma
- 6. • Goals of surgery: • 1. to decompress the following structures if under pressure: optic apparatus, pituitary gland, cavernous sinus, third ventricle (relieving hydrocephalus) • 2. obtain tissue for pathology • 3. complete removal of tumor is usually not necessary • 4. for hydrocephalus: ventricular drainage is generally required
- 7. •Pasien dengan riwayat lapangan pandangan menyempit 2 tahun •Gangguan haid sejak 1 tahun lalu •Apajah craniofaringioma dapat meningkatkan prolaktin?
- 8. • 3 bulan lalu nyeri kepala dan padangan kabur • gangguan • baru saat itu dia berobat ke dokter mata • disertai dengan gambaran ct scan, lesi mengisi sella suprasella, balloning sella, batas tegas, gambaran fluid gradation di lesi • Apakah ini suatu apopleksi? dengan perdarahan kronis • Apakah gambaran fluid gradatian suatu central nekrosis