IJNS 2016; 05(02): 084-088
DOI: 10.1055/s-0036-1584591
Original Article
Thieme Medical and Scientific Publishers Private Ltd.

Reduction in Cutis Verticis Gyrata after Transsphenoidal Pituitary Resection of Growth Hormone–Secreting Adenoma

Daniel Pinggera
1  Department of Neurosurgery, Medical University Innsbruck, Innsbruck, Austria
,
Delia Anna Marsoner
1  Department of Neurosurgery, Medical University Innsbruck, Innsbruck, Austria
,
Marcel Seiz-Rosenhagen
2  Department of Neurosurgery, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany
,
Claudius Thomé
1  Department of Neurosurgery, Medical University Innsbruck, Innsbruck, Austria
,
Christian Franz Freyschlag
1  Department of Neurosurgery, Medical University Innsbruck, Innsbruck, Austria
› Author Affiliations
Further Information

Publication History

26 December 2015

03 February 2016

Publication Date:
19 July 2016 (eFirst)

Abstract

Aim Cutis verticis gyrata (CVG) describes a hypertrophy and folding of the skin that appears as gyration of the scalp. Secondary CVG is a common symptom of growth hormone (GH)–producing adenoma of the pituitary and an early sign of acromegaly. We hypothesized that surgical removal of a pituitary adenoma with a consecutive decrease in hormone levels will cause a reduction in gyration.

Methods Imaging and laboratory examination of 10 patients (median age: 44 years) with GH-producing adenoma have been evaluated retrospectively. Surgical treatment consisted of endonasal transsphenoidal resection of the adenoma, followed by endocrinologic and radiographic follow-up. CVG was calculated as area under the curve of the scalp on preoperative coronal T1-weighted MRI, compared with postoperative follow-up imaging after 12 months (AUC, measured in cm2). In laboratory examination, the levels of insulin-like growth factor-1 (IGF-1) were analyzed accordingly as its levels are constant throughout the day.

Results After 12 months, we found a statistically significant (p = 0.008) correlation between the decrease in IGF-1 levels (median: 219.00 ng/mL) and the reduction in CVG (median: 0.12 cm2).

Conclusion Resection of GH-producing pituitary adenoma leads to a decrease in CVG in patients suffering from acromegaly, which is strongly related to the levels of IGF-1