This illustration was created for a May 2015 AFP article reviewing the diagnosis and management of GAD and PD in the primary care setting. While GAD and PD can develop among children and adolescents, diagnosis and care for these younger populations requires special considerations beyond the scope of this review.
Generalized anxiety disorder (GAD) and panic disorder (PD) are among the most common mental disorders in the United States. Frequently encountered by primary care physicians, both GAD and PD can negatively impact a patient’s quality of life and disrupt important activities of daily living. Evidence suggests that missed- and misdiagnosis of GAD and PD are high, with symptoms frequently ascribed to physical causes.
Both GAD and PD can negatively impact a patient’s quality of life and disrupt important activities of daily living. Missed- and misdiagnosis of GAD and PD are high, with symptoms frequently ascribed to physical causes.
This illustration was produced for the Johns Hopkins University’s Suburban Hospital Magazine, New Directions, Fall 2012 issue.
A craniopharyngioma is a benign tumor that develops near the pituitary gland (a small endocrine gland at the base of the brain). This tumor most commonly affects children 5 – 10 years of age. Adults can sometimes be affected. Boys and girls are equally likely to develop this condition.
Craniopharyngioma causes symptoms in the following ways:
- Increasing the pressure on the brain (intracranial pressure)
- Disrupting the function of the pituitary gland
- Damaging the optic nerve
Increased pressure on the brain causes headache, nausea, vomiting (especially in the morning), and difficulty with balance. Damage to the pituitary gland causes hormone imbalances that can lead to excessive thirst, excessive urination, and stunted growth. When the optic nerve is damaged by the tumor, vision problems develop. These defects are often permanent, and may get worse after surgery to remove the tumor.
Behaviorial and learning problems may be present. Most patients have at least some vision problems and evidence of decreased hormone production at the time of diagnosis.
Traditionally, surgery has been the main treatment for craniopharyngioma. However, radiation treatment instead of surgery or along with a smaller surgery may be the best choice for some patients. In tumors that cannot be removed completely with surgery alone, radiation therapy is usually necessary. If the tumor has a classic appearance on CT scan, a biopsy may not be necessary if treatment with radiation alone is planned. Stereotactic radiosurgery is performed at some medical centers. This tumor is best treated at a center with experience in treating patients with craniopharyngiomas. [Source: A.D.A.M. Medical Encyclopedia.]
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