Original scientific paper

Reversible »Brain Atrophy« in Patients with Cushing’s Disease

Živko Gnjidić
Tomislav Sajko
Nenad Kudelić
Maša Malenica
Branka Vizner
Milan Vrkljan
Josip Hat
Zoran Rumboldt

Abstract

During the past 25 years, we came across 60 patients with corticotroph pituitary adenomas and Cushing’s disease.
Neuroradiological examination showed prominent volume loss of the brain parenchyma, unexpected for the patient’s
age. This »brain atrophy« appeared to regress after surgical removal of pituitary adenoma and normalization of cortisol
level. Observed difference between degree of »brain atrophy« in the Cushing’s disease group and in the control group was
statistically significant (p<0.001). The degree of »brain atrophy« correlated well with the duration of Cushing’s disease.
Partial reversibility of »brain atrophy« was noticed during the 2nd, 3rd and 4th year after surgery and normalization of
cortisol level. Increased cortisol level is one of the causative factors in pathogenesis of »brain atrophy«. Loss of brain volume
is at least partially reversible after normalization of cortisol levels.

Keywords

Cushing’s disease; brain atrophy; pituitary ACTH adenoma; hypercortisolism; transsphenoidal surgery; CT; MRI; reversibility

Hrčak ID:

34303

URI

https://hrcak.srce.hr/34303

Publication date:

1.12.2008.

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