RESUMO
The authors present two cases of patients with craniopharyngiomas who meet the DSM-III-R criteria for intermittent explosive disorder. Episodes of rage developed before and/or after surgery for removal of the craniopharyngioma. Magnetic resonance imaging revealed hypothalamic-hypophyseal involvement. It is suggested that hypothalamic lesions played a major role in the development of aggressive behavior in both cases.
Assuntos
Agressão/fisiologia , Craniofaringioma/fisiopatologia , Sistema Hipotálamo-Hipofisário/fisiopatologia , Transtornos Neurocognitivos/fisiopatologia , Neoplasias Hipofisárias/fisiopatologia , Violência , Adulto , Agressão/psicologia , Craniofaringioma/psicologia , Feminino , Seguimentos , Humanos , Imageamento por Ressonância Magnética , Masculino , Transtornos Neurocognitivos/psicologia , Exame Neurológico , Testes Neuropsicológicos , Neoplasias Hipofisárias/psicologiaRESUMO
Three cases of intracranial meningiomas occurring in young pregnant women are presented. The typical growth pattern of these tumors is slow, producing insidious and chronic visual disturbances. In contrast, during pregnancy meningiomas may follow a rapidly progressive course, producing dramatic and relatively acute visual loss. This accelerated growth pattern is probably mediated by hormone receptors in these tumors. Nausea, vomiting, and other symptoms caused by the tumor may be attributed to pregnancy, delaying the diagnosis. Symptoms may abate spontaneously after delivery only to recur with greater rapidity and severity during subsequent pregnancies. Hormone-responsive intracranial meningiomas must be considered in the differential diagnosis of visual disturbances during pregnancy. Close cooperation between the ophthalmologist, neurosurgeon, obstetrician, and neonatologist is essential for an optimal outcome. Although surgical excision remains the treatment of choice, hormonal therapy may be valuable in treating unresectable or partially resectable meningiomas.