小结
定义
病史和体格检查
关键诊断因素
- 视力丧失
- 巨颅症和脑积水
- 生长迟缓
其他诊断因素
- 促性腺激素分泌不足导致的性腺机能减退症状（闭经、勃起功能障碍）
- 头痛
- 颅内压升高的症状（恶心、呕吐、感觉减退和复视）
- 溢乳
- 视神经萎缩
- 烦渴/多饮
危险因素
- 年龄 5-14 岁
- 年龄 50 至 70 岁
诊断性检查
首要检查
- 眼科评估；电脑化视野检查
- 颅脑 MRI 检查（造影剂增强）
- 脑 CT 检查（造影剂增强）
- 血清催乳素
- 血清生长激素 (growth hormone, GH)
- 血清胰岛素样生长因子 1 (insulin-like growth factor 1, IGF-1)
- 血清胰岛素样生长因子结合蛋白-3 (insulin-like growth factor binding protein-3, IGFBP-3)
- 生长激素（GH）激发试验
- 血清黄体生成素
- 血清卵泡刺激素
- 晨间血清睾酮
- 血清促甲状腺激素和 T3/T4
- 清晨血清皮质醇和促肾上腺皮质激素（ACTH）
- 血清电解质
- 尿和血清渗透压
- 尿比重
- 测骨龄的 X 线平片
需考虑的检查
- 组织学
治疗流程
初始治疗
初始治疗后
撰稿人
作者
Marc C. Chamberlain, MD
Chief
Division of Neuro-Oncology
Department of Neurology and Neurological Surgery
University of Washington
Seattle Cancer Care Alliance
Seattle
WA
利益声明
MCC declares that he has no competing interests.
鸣谢
Dr Marc C. Chamberlain would like to gratefully acknowledge Dr Daniel L. Silbergeld, a previous contributor to this topic.
利益声明
DLS declares that he has no competing interests.
同行评议者
Larry Junck, MD
Professor of Neurology
Department of Neurology
University of Michigan
Ann Arbor
MI
利益声明
LJ declares that he has no competing interests.
Jeff Raizer, MD
Associate Professor of Neurology
Director of Medical Neuro-Oncology
Northwestern University
Chicago
IL
利益声明
JR declares that he has no competing interests.
Ramez Kirollos, MBChB, FRCS(Ed), FRCS(Eng), MD, FRCS(SN)
Consultant Neurosurgeon
Addenbrooke's Hospital
Cambridge University Hospitals NHS Foundation Trust
Cambridge
UK
利益声明
RK declares that he has no competing interests.
Keyoumars Ashkan, BA, BSc, MB BCh, MRCP, FRCS, FRCPS, FRCS(SN), MD
Consultant Neurosurgeon and Lead of Neuro-Oncology
King's College Hospital
London
UK
利益声明
KA declares that he has no competing interests.
Edwin S. Kulubya Jr., MD, MBA
Neurosurgical Research Fellow
UC Davis Medical Center
Sacramento
CA
利益声明
EK declares that he has no competing interests.
鉴别诊断
- 垂体腺瘤
- 隔膜脑膜瘤
- 视交叉表皮样囊肿
更多 鉴别诊断指南
- 儿童肿瘤生存者的长期随访
更多 指南
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