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Grand Rounds, Episode 3: Disorders of Cortisol Secretion Related to Adrenal Conditions
Episode 3: Dr. Blevins focuses on the diagnostic process of endogenous hypercortisolism by following a patient's diagnosis and treatment process with hypercortisolism related to a functioning, cortisol-producing adrenal adenoma. It is particularly noteworthy that most people affected by this condition don't have the overt features of Cushing's syndrome.
Ana's story highlights adrenal diseases and the fact that some people with high cortisol levels are going to look like the classic patient with hypercortisolism, with symptoms and signs but not the textbook picture of Cushing's. It was Ana's work to push forward to get a diagnosis and understand what was going on with her, which led to a diagnosis that might have been otherwise considerably delayed. Ana walks us through her struggle and her substantial emotional challenges, including mood changes, depression, and anxiety.
Dr. Blevins walks us through Ana's final diagnosis with a thorough clinical discussion, leading to an excellent discussion of cortisol levels affecting mental acuity and physical challenges.
We focus on this adrenal condition in our pituitary grand round series as more than 50% of the patients that Dr. Blevins sees with adrenal tumors that produce cortisol were originally referred with the incorrect suspicion of having a pituitary cause of Cushing syndrome.
Переглядів: 308

Відео

A Rational Approach to Management of Craniopharyngioma
Переглядів 2174 місяці тому
A Pituitary World News production in collaboration with the Raymond A. Wood Foundation
Pituitary World News Grand Rounds Ep 2 Final v2
Переглядів 4438 місяців тому
The second episode of Pituitary Grand Rounds features Dr. Lewis Blevins in a compelling discussion with Sloan Hart, a patient with a dangerous, delayed diagnosis of Cushing's disease, which caused tremendous hardship and suffering.
Pituitary Grand Rounds Episode 1
Переглядів 606Рік тому
Pituitary Grand Rounds Episode 1
Neurosarcoidosis (Mass lesion in the sella)
Переглядів 282Рік тому
Dr. Blevins discusses an interesting case of neurosarcoidosis showing a lesion when it was most active and concludes with a view twelve years later after it burned out. Neurosarcoidosis is characterized by inflammation and abnormal cell deposits in any part of the nervous system-the brain, spinal cord, or peripheral nerves. It most commonly occurs in the cranial and facial nerves, the hypothala...
MRI review of a patient with hypoprolactinemia.
Переглядів 7323 роки тому
Dr. Lewis Blevins describes the image and points out interesting findings from this fascinating scan
A partially resected pituitary macro adenoma
Переглядів 4133 роки тому
This is a pituitary MRI video of a partially resected macro adenoma where the residual tumor has grown in size. This patient has hypopituitarism.
A radiology study of a pituitary macro adenoma
Переглядів 1,4 тис.3 роки тому
A discussion of an MRI radiology study of a patient with a fascinating case of hypergonadism.
Neuro sarcoidosis and empty sella
Переглядів 4,4 тис.4 роки тому
An excellent MRI discussion by Dr. Blevins to learn about and visualize the anatomy of a pituitary scan. This comparison of two MRI's, done 6 years apart, shows a case of a patient with neuro-sarcoidosis (abnormal masses or nodules, called granulomas, consisting of inflamed tissues). The second MRI illustrates a secondary empty sella.
An unusual case of hyperprolactinemia - IMG 2901
Переглядів 9864 роки тому
In this video of an MRI Dr. Blevins illustrates an unusual case of hyperprolactinemia. This is also a great opportunity to learn about MRI views as he describes some of the anatomies.
A video of an MRI of a patient with Cushing's syndrome that was ACTH apparent
Переглядів 1,3 тис.4 роки тому
In the video Dr Blevins describes the features of Nelson Syndrome, which is a pituitary tumor that becomes clinically apparent after initial surgery.
A large tumor producing high levels of prolactin
Переглядів 3,4 тис.4 роки тому
This story illustrates why it's so important to get a good pituitary surgeon. It shows an excellent MRI image of a large tumor from a 37-year-old patient that presented with hypogonadism. Dr. Blevins discusses the case and provides an excellent explanation of what you see in the MRI pre and postoperative.
Double pituitary adenomas in a patient with acromegaly
Переглядів 1,1 тис.5 років тому
Double pituitary adenomas in a patient with acromegaly
Sphenoid sinus mucocele
Переглядів 5 тис.5 років тому
Sphenoid sinus mucocele
Partial empty sella IMG 3514
Переглядів 11 тис.5 років тому
Partial empty sella in a patient with hypergonadism and hyperprolactinemia.
Metastasis to the pituitary region
Переглядів 5235 років тому
Metastasis to the pituitary region
An incidental pituitary lesion
Переглядів 1,6 тис.5 років тому
An incidental pituitary lesion
One patient's diagnosis story
Переглядів 7 тис.5 років тому
One patient's diagnosis story
ACTH-producing microadenoma
Переглядів 2,9 тис.5 років тому
ACTH-producing microadenoma
Normal Posterior Pituitary Gland
Переглядів 1,5 тис.5 років тому
Normal Posterior Pituitary Gland
Hemorrhagic prolactinoma
Переглядів 1,4 тис.5 років тому
Hemorrhagic prolactinoma
Pituitary macroadenoma with hydrocephalus
Переглядів 6465 років тому
Pituitary macroadenoma with hydrocephalus
Cystic Lesion in Sella
Переглядів 6455 років тому
Cystic Lesion in Sella
Craniopharyngioma
Переглядів 8365 років тому
Craniopharyngioma
Nonfunctional Macroadenoma
Переглядів 8155 років тому
Nonfunctional Macroadenoma
Rathke’s Cleft Cyst
Переглядів 3,4 тис.5 років тому
Rathke’s Cleft Cyst
Anatomical findings after Endoscopic Pituitary Surgery
Переглядів 4475 років тому
Anatomical findings after Endoscopic Pituitary Surgery
Residual Tumor In Cavernous Sinus
Переглядів 7495 років тому
Residual Tumor In Cavernous Sinus
Normal Pituitary Gland
Переглядів 16 тис.5 років тому
Normal Pituitary Gland
Macroadenoma
Переглядів 1,3 тис.5 років тому
Macroadenoma

КОМЕНТАРІ

  • @evanm6739
    @evanm6739 Місяць тому

    Dude my pituitary is like twice that size I’m still waiting for the radiologist report

  • @evanm6739
    @evanm6739 Місяць тому

    Oh man you should see mine

  • @AbdullayevUlugʻbek
    @AbdullayevUlugʻbek 2 місяці тому

    Oʻzbekcha tarjimasi bormi

  • @JoanGriffin-wd2sv
    @JoanGriffin-wd2sv 3 місяці тому

    I had a large pituitry tumour de bulked 5 years ago extended crainiotomy. had severe headaches for three years after have had raditherapy and take daily injections to reduce growth hormone only since the radio therapy have headaches become less severe.

  • @ALeishaGrey88
    @ALeishaGrey88 3 місяці тому

    Hi i have Partial empty sella, what effects and symptoms can it cause me ? As i was thinking i have Cushings syndrome. Thankyou

    • @LunaAnna7
      @LunaAnna7 2 місяці тому

      Do you have sleep apnea? Is your hematocrit high? And your hemoglobin?

    • @Savemyname7_
      @Savemyname7_ 12 днів тому

      it can crash the pituitary gland and leads to homones defiency

  • @theoak64
    @theoak64 3 місяці тому

    11:43 I get used get ocular migranes. But now they moved into something different, what i get now is it feels like pressure on the top of my head no real pain just pressure and then i get physically wiped out for 2 days. Lately i've been waking up at night with screaming headaches and I can hear the blood flowing though my ears. And my blood pressure is perfect every time it's been checked.

    • @pwnpituitaryworldnews9005
      @pwnpituitaryworldnews9005 3 місяці тому

      Thank you for watching and sending us your comments. Please stay tuned for more important information on all aspects of pituitary conditions.

  • @FranciscoRamirez-nl9dw
    @FranciscoRamirez-nl9dw 4 місяці тому

    My wife has had Pituitary surgery three times since 2010. The first two through the nose and the third through the skull. Discussed the headaches with the neurosurgeon and his response was, take some Tylenol, there is nothing more i can do. He did suggest that we get a second opinion. He didn't recommend any other doctor locally. Wants us to go to MD Anderson or Mayo clinic. Hard to believe that there are no other doctors we can see here in Dallas.

  • @gokdenizverstappen
    @gokdenizverstappen 4 місяці тому

    🇹🇷

  • @JAYGMART
    @JAYGMART 5 місяців тому

    Yup good explanation. I had this exact problem. Took 15 years for Drs to diagnose.

  • @ScienceInMedicine
    @ScienceInMedicine 6 місяців тому

    you are a great teacher!

  • @Kasonas
    @Kasonas 7 місяців тому

    Has this patient been followed up with radiation? I was told by my neurosurgeon that because my tumor is big and invaded the cavernous sinus, that he won't be able to get it all, but will follow up with radiation aprox 3 months post surgery.

  • @deepmalakumari8500
    @deepmalakumari8500 8 місяців тому

    Thank you for this wonderful video...i was looking for something like this

  • @teeski693
    @teeski693 8 місяців тому

    What an incredible lady! Thank you for sharing your story. You are not alone, there are many of us out here with Cushing’s and hearing about your experience is just so helpful. Thank you Dr. Blevins. Great video!

  • @pedro-e-o-lobo
    @pedro-e-o-lobo 8 місяців тому

    Ninja Sex Parties

  • @elenagiurgiuman5624
    @elenagiurgiuman5624 10 місяців тому

    Hello Dr. Lewis! I foud PWN very interesting on my case and I want to ask for your help! Thank you!

  • @kauaireed9006
    @kauaireed9006 Рік тому

    Thanks for taking the time to make this video !!!

  • @swipe87
    @swipe87 Рік тому

    What a great inaugural episode. Thank you PWN for putting this on and thanks Mr. Jackson for being brave enough to share your story.

  • @tommytommy7096
    @tommytommy7096 Рік тому

    Very interesting, I had my tumor in my pituitary removed in 1988, and I still remember today the massive headache I had in recovery. It was nasty and painful but after about six months, Doctor was right no more pain just pills for the rest of my life. I thank God I was lucky the acromegaly I was diagnosed with at a young age.

    • @pugalnk8973
      @pugalnk8973 Рік тому

      You till taking pills for headache or something?

  • @profmj7630
    @profmj7630 Рік тому

    Thanks doctor for sharing

  • @sergeyshchurko9541
    @sergeyshchurko9541 Рік тому

    Have you heard of tubarial glands? ua-cam.com/video/Zlq1IW6qNKI/v-deo.html

  • @eltiarribero
    @eltiarribero Рік тому

    One the largest I've seen in my 20 years as a MR Technologist. Nice video.

  • @Aethrin
    @Aethrin Рік тому

    Northumbrian Small Pipes always make yearn to sit with my feet in a creek or run through fields of grain. It's the sound of a humble and happy summer, briefly bending down and kissing me on the cheek, and it makes me cry every time.

  • @jessevinson3195
    @jessevinson3195 Рік тому

    Do you ever see a pituitary stalk with a cyst?

  • @jessevinson3195
    @jessevinson3195 Рік тому

    Have you ever dealt with, seen a cyst on the pituitary stalk?

  • @jessevinson3195
    @jessevinson3195 Рік тому

    Can a cyst be on the stalk of pituitary?

  • @jeremycrisman2434
    @jeremycrisman2434 Рік тому

    Well done! Excellent piping 🎶

  • @michelledann7824
    @michelledann7824 Рік тому

    Dr. Blevins diagnosed me at Vanderbilt. I was 16. I’m 35 now.

  • @sukratishrivastava5933
    @sukratishrivastava5933 Рік тому

    Very bad explanation

  • @Unek0777
    @Unek0777 Рік тому

    I had a CT Sinus done & today, I follow up with my ENT for my results. I am so scared. I read that I have “mucosal thickening in the sphenoid sinuses.” How is that treated? I’m scared to have any type of surgery UNLESS I am awake 😩

  • @patsyizuorgu1703
    @patsyizuorgu1703 Рік тому

    8 years later and this video is still viable

  • @sermocaru
    @sermocaru Рік тому

    Thank you for the educational video. It helped me a lot.

  • @aakankshab2886
    @aakankshab2886 Рік тому

    Beautifully explained sir...thank you!

  • @Combat556
    @Combat556 Рік тому

    I’ve watched all of your presentations and learned a lot. I’ve had an MRI,with contrast, done recently for migraines. After viewing other pituitary imaging on your channel, I’m concerned about how my pituitary looks. There’s a black area in the corner of the left pituitary wing, and it’s very visible on the sagittal view. On the coronal view the dark spot is visible in the left corner and also the lower center. The pituitary appears to have a highlighted outline with a slightly darker contrast in the main body. There’s also an upward prominent hump at each end wing. There’s no visible optic chaism, and the upper carotid sipon on the left side is not visible? My pituitary doesn’t match anything that you’ve described on your channel. A endocrine Doctor at Cedars-Sinai has ordered a blood test. If I need any further testing or treatment, I will contact your department at UCSF. Thank you for sharing this information.

  • @MichelleWilliams-bm6uu
    @MichelleWilliams-bm6uu Рік тому

    I have pulmonary sarcoidosis (past 2 years) The inflimation of my lymph nodes shocked my doctors. I was treated for 6 mo with prednisone 20 mg and tapered. After being off prednisone, the my symptoms returned. This time they started me on 10 mg prednisone but doesn't seem to be helping the symptoms. I also have hypothyroid (for 25 years). I insisted my Endo do an MRI of my pituitary. Finds are a 3 mm granuloma on my pituitary but he doesn't think it's effecting my thyroid. The MRI also showed a 10mm left artery aneurysm which I'm seeing a neurosurgeon and planning on having it addressed. So my question, is it probable that I have granulomas in other parts of my brain?

  • @michaelrowland8328
    @michaelrowland8328 Рік тому

    If you don’t know what is going on the dam eye doctor will not send you for a mri are ct scan they will simply say we are getting older

  • @michaelrowland8328
    @michaelrowland8328 Рік тому

    Yes I am also going through this headaches pain behind the eye one side are the other hair feels like it’s been pulled all-night tenderness in the front of face and ear ache and tooth ache with drainage down to the stomach and the pressure from the eye never got any better

  • @منيرةالعنزي-ج7و

    Thank you for sharing that! That so helpful for medical students.

  • @watercolorsinbloom
    @watercolorsinbloom Рік тому

    I've been feeling intoxicated/drugged/dizzy for 4 months now, while being a sober person. I had a mucocele removed 2 weeks ago tomorrow, from my sphenoid, not sure how large. Plus scar tissue was blocking the opening so it was opened. I still feel the same way. Do you think it's related? I was hoping after surgery I would get better. Maybe 2 weeks isn't enough.

  • @lillyrocks2011
    @lillyrocks2011 Рік тому

    It's so beautiful. I love the sound. It's so magical. 🌠🙏🏼

  • @Crazywaffle5150
    @Crazywaffle5150 Рік тому

    Mines 1700 :(

  • @jenplusbloops4176
    @jenplusbloops4176 2 роки тому

    Neurons reordering at cores.

  • @FatBoyzAreUs
    @FatBoyzAreUs 2 роки тому

    I'm going through this right now, and I was able to get some tests started by physically showing my doctor what my body was doing to me with messed up hormones. I was almost walked out of the office as just "another fat guy doesn't like his manboobs." I've had these left-eye headaches, where it feels like an ice pick directly into your brainstem for up to 10-15 seconds. My estrogen levels, as a male btw, are hundreds of times more than a pregnant female. I progressed into gynecomastia, and now I literally have women's breasts. I produce milk as a male. I've been disregarded and told I'm making things up since I was a child. My hormones are so screwed up since puberty that my brain doesn't function like other peoples - I've developed pseudo-bipolar disorders, depression and anxiety attacks that will hit you for no reason with no triggers and completely incapacitate me. Recently these random attacks would hit me in the middle of almost any activity, and I've never experienced anything like this before, but several times now I've straight up ran away to a room alone, broke down and couldn't stop crying. Over nothing. I'm not sad or thinking about anything particular when it happens or as it is happening, but for some reason it physically hurts me, idk how to really describe it. If you or someone you know might be showing signs or symptoms described in this video or in the comments, I URGE YOU to go get your bloodwork done, specifically hormones like prolactin, cortisol, testosterone, ya know what check it all. Pituitary tumors affect your entire body through the screwing up of your hormones. If there's anyone in this situation feel free to reach out, there's not really a support group. Especially for males - this is extremely humiliating to not be a normal man: no facial hair, no body hair, almost zero testosterone production, overproduction of estrogen, hypogonadism, and even micro-penis and unascended testicles from the abdomen can occur if you had this since childhood untreated like so many other men.

  • @josephineapple7883
    @josephineapple7883 2 роки тому

    I hate having mine and meds don't agree with me

  • @alejandroecheverria7318
    @alejandroecheverria7318 2 роки тому

    why do you say that endocrinólogist or neurosurgeons are the ones that should be looking at these images. The fact that the radiologist missed the diagnosis is NOT enough to make a statment Like that. I have seen many specialist making wrong radiológic diagnosis

    • @abdulrazak1116
      @abdulrazak1116 Рік тому

      true that. truly unethical comment whoever he is..

    • @niceyesplease
      @niceyesplease Рік тому

      So true, that is the arrogance we as radiologist encounter all the time. Orthopedic surgeons, neurosurgeons, cardiologists you name it, many think they know CT or MRI better. But when it comes to putting their name under a report they get cold feet. Retrospectively it is always easy to criticize. Actually, this arrogance is dangerous for patients as it interrupts necessary interdisciplinary exchange that is needed nowadays.

  • @johnnyazer5779
    @johnnyazer5779 2 роки тому

    Hello Stanford, I have had a pituitary tumor since diagnosed in Rutland Vermont on May 12, 2003. The PC and also Dartmouth neurosurgeons said it was too risky to do transphenoidal and that I would have serious problems. Since living in Burlington Vermont, any time I have complained about the tumor, which is now a macroadenoma, since 2008, noone will do even anything at all here at UVM medical center in Burlington. They have told me not to worry about it, be lucky it has not killed me, or BS that pills will boost sugar levels. I appealed to neurosurgery directly and they had patient advocates call me. Nowhere. THEY WILL NOT DO ANYTHING. I have all types of symptoms in which they said is a mental problem. Lots know here but noone cares or not their problem in Vermont.

  • @Achristianhousewife2024
    @Achristianhousewife2024 2 роки тому

    I had a cyst in the pituitary in 1997 removed went through the mouth and sinus . 4 years ago I had this removed in sphenoid sinus same thing. And they said I had pituitary adenoma again I never went back for that in 2015 cat scan showed sinus mass and 1.4cm Adenoma. Could all this have come from the tissue from my leg they used to pack my sinus after surgery? Mris are expensive and I just haven’t had another one

  • @metalcooop
    @metalcooop 2 роки тому

    what is the main reason? it can be from family gen or foods or other things?

    • @sweetiepeach69
      @sweetiepeach69 Рік тому

      Chemicals in water, food, air etc... But some say Acromegaly isn't a disease, just a different genetic makeup.

    • @arravYT
      @arravYT Рік тому

      It can be genetic or in other rarer cases a hard hit to your head that causes that trigger.

    • @tecnicalgyusgaming728
      @tecnicalgyusgaming728 10 місяців тому

      It is due to hypersecrition of growth hormone

  • @twirlacane
    @twirlacane 2 роки тому

    A recent MRI revealed that have an empty Sella and a flattened pituitary. Naturally, I started researching on Google and UA-cam but all I could find were radiographic images. An actual skull was so much more helpful. Thanks!

  • @jodifacello-oberry7805
    @jodifacello-oberry7805 2 роки тому

    Do you or your colleagues take cases for 2nd opinion review of films?

  • @laurenmitchell4625
    @laurenmitchell4625 2 роки тому

    Can I send you some brain images and get your opinion? I'm trying to find answers about my husbands brain scans. I would really, really appreciate it. Thank you