Neuroendocrine disturbances after acquired brain damage

Hypopituitarism is not a rare disease and its clinical signs and symptoms deserve the attention of the clinically practising neurologist. Next to the classical cause of hypopituitarism mediated by tumours of the hypothalamo-pituitary region, a number of recent articles have highlighted the high frequency of central endocrine disturbances in patients with brain damage, i. e. not only after traumatic brain injury and subarachnoid haemorrhage but also as a consequence of the treatment of childhood brain tumours. This article provides an overview of the clinical symptomatology and pathophysiology of hypopituitarism as well as the current knowledge about neuroendocrine disturbances in the adult patient suffering from the above-mentioned disorders.     

Actinomycose pelvienne : un tableau trompeur

Pelvic actinomycosis is a rare chronic suppurative granulomatous disease associated with an intrauterine contraceptive device. Next pelvic organs can be affected but also more distant organs, to lead to different clinical situations. The diagnosis is therefore often difficult. We report here the case of a woman who presents a particular extensive pelvic actinomycosis diagnosed after surgical treatment with important morbidity. This case shows the interest of evoking the diagnosis in an evocator clinical contest, doing the necessary exams to confirm the hypothesis, favouring medical treatment and reserving surgical treatment for particular situations.