A unique exception of this rule

A unique exception of this rule are tumours at which Prolactinum level in can raise even at absence growth [136]. Rising of concentration of hormones in is caused, apparently, not by disturbance of integrity of a barrier between blood and , and, that is the most probable, immediate hit hormones in [135]. Though before it will be possible to estimate prognostic value of definition of level of hormones in , the further accumulation of experience zanaflex of such definitions is necessary, they can promote selection of patients with diffusion tumours. The differential diagnosis The diagnosis of a tumour of a pituitary body is based on revealing signs of tumoral mass and if it is possible, on the proof of a hypersecretion of hormones. In the presence of that and another the diagnosis does not cause doubts. The differential diagnosis of a hypersecretion of the hormones observed in absence of changes, is surveyed in following section. If the tumour does not possess hormonal activity many signs and clinical symptoms are dictated by necessity of the careful account of other diagnostic possibilities. It is necessary to underline, that a hypopituitarism, partial or full, at the data testifying to augmentation of the sizes or a destruction of a Turkish saddle, not necessarily specifies in a pituitary body tumour.
Differential diagnostics of the lowered function of a pituitary body already was discussed. Conditions at which observe augmentation of the sizes of a Turkish saddle, are listed in tab. 7-8 according to frequency of occurrence. At patients at whom the sizes of a Turkish saddle are enlarged, but sight, frequency primary tumours is not broken and a syndrome of an "empty" Turkish saddle was identical (36 and 33 ); damages (including tumours, and also the granulomatosis phenomena) were observed less often (17 ), and in the others of 14 of cases the diagnosis to establish it was not possible [137]. Other diseases mentioned in tab. 7-8, meet seldom, but nevertheless demand differentsialno-diagnostic and therapeutic approaches. Syndrome of an "empty" Turkish saddle The term an empty saddle apply in all cases when at a pneumoencephalography the Turkish saddle is filled with air. It is caused by subarachnoid space expansion in area and often accompanied a pituitary body usually along a back part of a bottom and a backrest. The Turkish saddle, as a rule (though and not always), is enlarged. The term tegretol a syndrome of initially "empty" Turkish saddle is applied when it is not bound to the previous surgical intervention or radial therapy. On a material initially "empty" Turkish saddle found out almost in 24 of cases; thus in the anamnesis usually there were no indicatings on endocrine disease [138]. The aetiology of a syndrome of initially "empty" Turkish saddle is obscure. Consider, that completely generated diaphragm of a saddle creates possibility of program of pressure on its contents, that gradually leads to a protrusion of a web cover with and reorganisations of the most Turkish saddle. Other possibility consists in preexistence of a tumour or a cyst with the subsequent hemorrhage and , leading to loss of mass of a tissue. Almost all cases of a syndrome of initially "empty" Turkish saddle are asymptomatic. Though often it becomes perceptible head The pain, but it, possibly, is not bound to a saddle condition, and simply serves as an occasion to skull roentgenography at which the diagnosis is established. This syndrome is observed at corpulent women more often and combined with the raised prevalence of an idiopathic hypertensia, a good-quality intracranial hypertensia (a brain pseudoneoplasm) and effluxes from a nose that is noted in tab. 7-9 [100, 101]. Visual disturbances, more often developing at the secondary form of a syndrome (after operation or radial therapy), meet and at a syndrome of initially "empty" Turkish saddle, including generalised narrowing of peripheric fields of vision, a bitemporal hemianopsia and a papilledema. The Turkish saddle is usually symmetrically enlarged or is dilated (84 of patients) but can be and is deformed (42 ), and straightening of a backrest with its demineralization more often is found out and is more rare - asymmetry of a bottom and erosion of the rejected processes. These changes can be indistinguishable from what meet at pituitary body tumours. The diagnosis establish by means of a pneumoencephalography. At changes of a configuration of a saddle with a pituitary body filling with its air is not an obligatory sign. Some researchers consider, that for acknowledgement of the diagnosis instead of a pneumoencephalography it is possible to use Kt-scanning whereas, according to other researchers, the majority of corresponding devices possesses diagnostic accuracy insufficient for this purpose.