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Angioplasty is an Effective Treatment for Vasospasm Following Pituitary Apoplexy and Tumor Resection

Pituitary apoplexy is a clinical syndrome characterized by acute headache, visual changes, and decreased consciousness occurring in association with hemorrhage or infarct of an existing pituitary adenoma. Surgical management involves tumor resection and decompression of surrounding structures includ...

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Autores principales: Douleh, Diana G, Morone, Peter J, Mobley, Bret, Fusco, Matthew R, Chambless, Lola B
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5871324/
https://www.ncbi.nlm.nih.gov/pubmed/29593947
http://dx.doi.org/10.7759/cureus.2117
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author Douleh, Diana G
Morone, Peter J
Mobley, Bret
Fusco, Matthew R
Chambless, Lola B
author_facet Douleh, Diana G
Morone, Peter J
Mobley, Bret
Fusco, Matthew R
Chambless, Lola B
author_sort Douleh, Diana G
collection PubMed
description Pituitary apoplexy is a clinical syndrome characterized by acute headache, visual changes, and decreased consciousness occurring in association with hemorrhage or infarct of an existing pituitary adenoma. Surgical management involves tumor resection and decompression of surrounding structures including the optic apparatus. Vasospasm is a rare but potentially devastating complication of pituitary apoplexy. We present a case of pituitary apoplexy in a 28-year-old male treated with emergent endoscopic transsphenoidal resection. On postoperative day seven, following  surgical resection, the patient developed neurologic deficits and motor weakness, and severe vasospasm was diagnosed. This is a novel case of intra-arterial verapamil and angioplasty used to treat vasospasm following surgical decompression for pituitary apoplexy. The patient experienced complete recovery of motor deficits following treatment. The authors propose angioplasty as an effective treatment for postoperative vasospasm following transphenoidal surgery for pituitary apoplexy in the presence of focal vessel stenosis.
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spelling pubmed-58713242018-03-28 Angioplasty is an Effective Treatment for Vasospasm Following Pituitary Apoplexy and Tumor Resection Douleh, Diana G Morone, Peter J Mobley, Bret Fusco, Matthew R Chambless, Lola B Cureus Neurosurgery Pituitary apoplexy is a clinical syndrome characterized by acute headache, visual changes, and decreased consciousness occurring in association with hemorrhage or infarct of an existing pituitary adenoma. Surgical management involves tumor resection and decompression of surrounding structures including the optic apparatus. Vasospasm is a rare but potentially devastating complication of pituitary apoplexy. We present a case of pituitary apoplexy in a 28-year-old male treated with emergent endoscopic transsphenoidal resection. On postoperative day seven, following  surgical resection, the patient developed neurologic deficits and motor weakness, and severe vasospasm was diagnosed. This is a novel case of intra-arterial verapamil and angioplasty used to treat vasospasm following surgical decompression for pituitary apoplexy. The patient experienced complete recovery of motor deficits following treatment. The authors propose angioplasty as an effective treatment for postoperative vasospasm following transphenoidal surgery for pituitary apoplexy in the presence of focal vessel stenosis. Cureus 2018-01-26 /pmc/articles/PMC5871324/ /pubmed/29593947 http://dx.doi.org/10.7759/cureus.2117 Text en Copyright © 2018, Douleh et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Neurosurgery
Douleh, Diana G
Morone, Peter J
Mobley, Bret
Fusco, Matthew R
Chambless, Lola B
Angioplasty is an Effective Treatment for Vasospasm Following Pituitary Apoplexy and Tumor Resection
title Angioplasty is an Effective Treatment for Vasospasm Following Pituitary Apoplexy and Tumor Resection
title_full Angioplasty is an Effective Treatment for Vasospasm Following Pituitary Apoplexy and Tumor Resection
title_fullStr Angioplasty is an Effective Treatment for Vasospasm Following Pituitary Apoplexy and Tumor Resection
title_full_unstemmed Angioplasty is an Effective Treatment for Vasospasm Following Pituitary Apoplexy and Tumor Resection
title_short Angioplasty is an Effective Treatment for Vasospasm Following Pituitary Apoplexy and Tumor Resection
title_sort angioplasty is an effective treatment for vasospasm following pituitary apoplexy and tumor resection
topic Neurosurgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5871324/
https://www.ncbi.nlm.nih.gov/pubmed/29593947
http://dx.doi.org/10.7759/cureus.2117
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