International Journal of Neurology and Neurosurgery

Van WykGrumbach syndrome is a constellation of hormonal abnormalities which includes hypothyroidism, precocious puberty and ovarian cysts in pre and pubertal girls. The usual presentation is ascites, pericardial and pleural effusion, enlarged pituitary, elevated prolactin, ovarian hormones. Here, we present a 6 year old female, who presented with precocious puberty associated with hypothyroidism and had features suggestive of Van Wyk– Grumbach syndrome. This is presented to highlight the rare presentations of Pediatric Sellar Pituitary enlargement with bleeding PV, walking difficulty, thelarche her hormonal profile showed elevated TSH, Prolactin, Inhibin B and LDH, USG abdomen showed multiple ovarian cysts with adrenal mass, MRI brain showed enlarged pituitary gland and bone scans revealed a delayed bone age. This rare entity should be kept in mind in cases of ovarian cysts, especially those with isosexual precocity, to prevent delay in medical management and unnecessary surgical misadventures. Keywords: Hypothyroidism; Pituitary; Vanwyk Grumbach.

Brucellosis is neglected but important zoonotic disease when it comes about spondylodiscitis. Here, we are presenting rare case of 54 years old male with brucellosis spondylodiscitis which is diagnosed by serum agglutinin test and had undergone L5-S1 Level discectomy with L5 Partial coprpectomy with L4-L5-S1 Screw and rod fixation for the same. Postoperative period was uneventful and he was discharged on fourth postoperative day with complete neurological recovery. Due to atypical presentation and prevalence of spinal tuberculosis, diagnosis of
brucellosis is challenging but with proper investigation battery and right treatment, patient can be saved from greater morbidity.
Keywords: Brucellosis; Spondylodiscitis; Zoonotic disease.
 

Pediatric pituitary adenomas (PPAs) are rare neoplasms sometimes with unusualpresentations and varied clinical course. We describe 2 atypical PPAs to highlight the clinical examination, radiological, hormonal and management aspects. A 6-year-old girl presented with bleeding per vagina with difficulty in walking with breast enlargement without visual disturbances. MRI revealed an enlarged anterior pituitary gland showing intense enhancement on contrast of size 11mm x 16mm without invasion of 3rd ventricle or parasellar extension into cavernous sinuswith USG Abdomen and pelvis revealing complex ovarian cyst with reduced TSH levels suggesting Primary Hypothyroidism. Another 30-year-old male presented with blurring of vision in both eyes with bilateral temporal field defects with absence of secondary sexual characters and decreased libido with decreased testosterone levels and MRI Brain showing non diffusion restricting T1 iso T2 hyperintense lesion in sellarsuprasellar region suggestive of Cystic pituitary macroadenoma with haemorrhage,which was managed surgically. Keywords: Adenoma; Medical; Pituitary; Surgery.