Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • visual loss
  • macrocephaly and hydrocephalus
  • growth failure

Other diagnostic factors

  • symptoms of hypogonadotrophic hypogonadism (amenorrhoea, erectile dysfunction)
  • headache
  • symptoms of intracranial hypertension (nausea, vomiting, decreased sensorium, diplopia)
  • galactorrhoea
  • optic atrophy
  • polyuria/polydipsia

Risk factors

  • age 5 to 14 years
  • age 50 to 70 years

Diagnostic investigations

1st investigations to order

  • MRI brain (contrast-enhanced)
  • CT brain (contrast-enhanced)
  • serum prolactin
  • serum growth hormone (GH)
  • serum insulin-like growth factor 1 (IGF-1)
  • serum insulin-like growth factor binding protein-3 (IGFBP-3)
  • provocative GH tests
  • serum LH
  • serum FSH
  • morning serum testosterone
  • serum TSH and T3/T4
  • morning serum cortisol and ACTH
  • serum electrolytes
  • urine and serum osmolality
  • urine specific gravity
  • ophthalmological evaluation; computerised visual-field examination
  • plain x-rays for bone age
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Marc C. Chamberlain

Chief

Division of Neuro-Oncology

Department of Neurology and Neurological Surgery

University of Washington

Seattle Cancer Care Alliance

Seattle

WA

Disclosures

MCC declares that he has no competing interests.

Daniel L. Silbergeld

Professor of Neurological Surgery and Pathology (Neuropathology)

University of Washington

Seattle

WA

Disclosures

DLS declares that he has no competing interests.

Peer reviewers VIEW ALL

Professor of Neurology

Department of Neurology

University of Michigan

Ann Arbor

MI

Disclosures

LJ declares that he has no competing interests.

Associate Professor of Neurology

Director of Medical Neuro-Oncology

Northwestern University

Chicago

IL

Disclosures

JR declares that he has no competing interests.

Consultant Neurosurgeon

Addenbrooke's Hospital

Cambridge University Hospitals NHS Foundation Trust

Cambridge

UK

Disclosures

RK declares that he has no competing interests.

Consultant Neurosurgeon and Lead of Neuro-Oncology

King's College Hospital

London

UK

Disclosures

KA declares that he has no competing interests.

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