Neuropsychological sequelae of a pituitary germinoma: A case study

Abstract

We report the case of a right-handed adolescent male with a history of a pituitary germinoma. Developmental history was reportedly unremarkable and a conservative estimate of the level of cognitive function before his illness, based on reported academic performance, places this individual in the low average range of intellectual ability. Subsequent resection of the tumor resulted in a lesion in the right mesial basal orbitofrontal region involving the tuber cinereum, lamina terminalis, gyrus rectus, olfactory gyrus and diagonal band of Broca. Initial evaluation revealed profoundly impaired memory for both verbal and visual-spatial information. Follow-up evaluations at 4, 24 and 42 months further substantiated profound impairments in memory for both verbal and visual-spatial information, as well as behavioral problems involving emotional lability and disinhibition. Given the location of this lesion, it is suggested that this patient's profound deficits in memory are due to disruption of both the Papez circuit and the lateral limbic circuit, which are known to be involved in the memory system.

Key Words:

• pituitary germinoma
• lateral limbic circuit
• Papez circuit
• memory dysfunction
• amnesia