Pa: 08-25 - COS
surrounded the upper intrasellar portion of the pituitary stalk.
There was
no other evidence of tumor within the gland and it was felt that this may
have been the cause of the patient's hypoprolactinemia.
Following surgery,
the patient had a rather uneventful course except for development of a
persistent CSF leak.
SHe was then brought back down to the Neurosurgical
Service on Septmber 8 and had an indwelling subarachnoid drainage catheter
placed for three to four days via a lumbar puncture.
The results of the CSF
that was obtained at that time; there were two white blood cells, 200 red
blood cells, her glucose was 78@ and her protein was 34.
The patient
remained on drainage for five days and after removal of the drain, had no
Further CSF or rhinorrhea.
She has remained afebrile without any
postoperative complications.
Laboratory data followdng her surgery ~- her white blood count was
10,400, hemoglobin 12.0, hematocrit 34, platelet count 408,000,
potassium 4.4, chloride 100, bicarbonate 28, BUN 18, creatinine
sodium 141,
1.3.
Her T
3
was 125, T,
9.6, free T,
1.7.
ACTH stimulation test after surgery, her 0
time was of. 7, 30 minutes post ACTH her cortisol was 30.8 and at 60 minutes
her cortisol was 38.9.
It was felt that the patient had had a relatively
uncomplicated hospital course and has done well.
OPERATIONS AND DATES PERFORMED:
As noted the patient underwent a transsphenoidal hypophysectomy on
September 1, 1982.
°@
Hyperprolactinema.
Galactorrhea/amenorrhea, secondary to number
Status-post transsphenoidal hypophysectony.
1.
History of abnormal liver function tests... At this time the only
abnormality is a slight elevation in her SGPT, all the other numbers
se
ww hb =
CLINICAL DIAGNOSES:
have normalized.
On return visit here these should be repeated
again.
Slightly elevated white count and platelet count.
Again, these are
only mild elevations and should just be followed when the patient
3.
returns.
6.
History of parasites in the stool.
This is thought, to not be
causing her any chronic debilitation since the patient has no
evidence of malabsorption and this is probably secondary to the
living situation and on follow-up the patient should just be
questioned about persistent diarrhea and whether she would be
developing any symptoms of malabsorption.
This was felt to be
benign when she was seen by Infectious Diseases on her last visit in
January of 1982.
Admitted on 8-23-82
Discharged on 9-24-82
;
.
(—] Operation Report (OPN)
(_] History and Physica! Examination (HPE)
Discharge Summary (DS)
{(_] DS Combined with HPE
[_} Interim Summary (15)
{_] IS Combined with HPE
[_] Addendum Summary (AS)
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