NeoplasmCerebral atrophy in Cushing’s disease
Section snippets
Materials and methods
Sixty-three patients (15 men, 48 women) were retrospectively analyzed in the study, having undergone evaluation and treatment for Cushing’s disease at the University of Virginia Medical Center between July 1992 and December 1995. All patients were operated on by the senior author (ERL) and proven to have adrenocorticotropin hormone (ACTH)-secreting tumors on pathological analyses. Cerebral imaging studies (CT and MRI) obtained during the patient’s treatment period were reviewed. Additionally,
Results
Primary analysis assessed the difference in the grading of atrophy between CT and MRI scans. A total of 53 scans were evaluated in which both forms of imaging were available. The average degree of atrophy for all patients with Cushing’s disease was 1.0 (SD = 1.0) when using CT grading and 1.1 (SD = 0.7) when using MRI. No difference was identified between the two imaging techniques (p = 0.135).
Comparison of patients with Cushing’s disease (mean, 1.1) and controls (mean, 0.44) revealed a
Discussion
The systemic effects of the hypercortisolemic state manifested in Cushing’s disease are well known 1, 7. The elevated cortisol levels cause catabolic changes which are typically demonstrated by atrophic changes in bone and soft tissues. Such changes include osteoporosis, muscle atrophy, easy bruising, and cutaneous striae. Emotional and cognitive changes are also well correlated with excess steroid administration 1, 5, 7.
With regard to effects on the central nervous system, Bentson described an
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