Evidence map›Paper›PMID 40327154›Full record

ArticleLangenbeck's archives of surgery2025

Cabergoline-induced cerebrospinal fluid fistulae in macroprolactinomas.

Elvis J Hermann, Sabine Hertz, Makoto Nakamura, Christoph Terkamp, Thomas M Kinfe, Stefan Stolle, Holger Leitolf, Rudolf Fahlbusch, Joachim K Krauss

Abstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in Langenbeck's archives of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Elvis J Hermann *Department of Neurosurgery, Hannover Medical School, Carl-Neuberg-Str.1, 30625, Hannover, Germany. Hermann.Elvis@mh-hannover.de.
Sabine Hertz *Department of Neurosurgery, Hannover Medical School, Carl-Neuberg-Str.1, 30625, Hannover, Germany.
Makoto NakamuraDepartment of Neurosurgery, Klinikum Köln-Merheim, Köln, Germany.
Christoph TerkampDepartment of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.
Thomas M KinfeDepartment of Neurosurgery, Mannheim Center for Neuromodulation and Neuroprosthetics, Medical Faculty Mannheim, Ruprecht-Karl-University, Heidelberg, Germany.
Stefan StolleDepartment of Laryngology, Rhinology and Otology, Hannover Medical School, Hannover, Germany.
Holger LeitolfDepartment of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.
Rudolf FahlbuschDepartment of Neurosurgery, International Neuroscience Institute, Hannover, Germany.
Joachim K KraussDepartment of Neurosurgery, Hannover Medical School, Carl-Neuberg-Str.1, 30625, Hannover, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeCerebrospinal fluid (CSF) rhinorrhea is a rare complication after dopamine agonist treatment of macroprolactinomas. Up to 90% need surgical repair, however, there are controversial opinions on the necessity of tumor resection upon this occasion. Here we present our long-term follow-up experience in patients who underwent surgical repair of the CSF leak or observation.

methodsWe report a series of three patients who presented with cabergoline-induced CSF rhinorrhea with long-term follow-up up to 170 months. Two patients underwent endoscopic transnasal-transsphenoidal surgical repair of CSF rhinorrhea by fat graft and fibrin glue without tumor removal. In another patient, CSF rhinorrhea resolved spontaneously after two weeks without recurrence.

resultsAll three patients had no recurrence of CSF rhinorrhea during long-term follow-up up to 170 months. One patient with surgical CSF leak repair was asymptomatic with continued medication at long-term follow-up of 116 months. Tumor progression occurred 21 months after CSF leakage repair in another patient after cessation of dopamine agonist treatment and necessitated tumor debulking. The patient with continued medication without surgery had no recurrence of CSF rhinorrhea on long-term follow-up of 170 months.

conclusionThe optimal management of CSF fistulae due to tumor shrinkage of macroprolactinomas after dopamine agonist therapy remains to be defined. Exceptionally, medication-induced CSF fistulae in response to tumor shrinkage may close spontaneously without recurrence. If persistent, transnasal-transsphenoidal closure of CSF fistulae represents an efficient treatment and dopamine agonist treatment may be continued. Thus, we recommend early surgical repair.

Indexed as

Antineoplastic AgentsCerebrospinal Fluid RhinorrheaDopamine AgonistsErgolinesPituitary NeoplasmsProlactinomaCabergolineFollow-Up StudiesHumansAntineoplastic AgentsCabergolineDopamine AgonistsErgolinesCerebrospinal fluid fistulaCerebrospinal fluid leakDopamine agonistPituitary adenomaProlactinomaRhinorrhea

Identifiers

PMID40327154
PMCPMC12055877

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