Cargando…
Pituitary apoplexy causing acute ischemic stroke: Which treatment should be given priority
BACKGROUND: Pituitary apoplexy is syndrome of sudden onset of headache, visual loss, pituitary dysfunction, and altered consciousness. Pituitary apoplexy followed by acute cerebral ischemia is extremely rare. Here, we introduced the case of successful surgical resection of pituitary adenoma which in...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Scientific Scholar
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7265385/ https://www.ncbi.nlm.nih.gov/pubmed/32494388 http://dx.doi.org/10.25259/SNI_82_2020 |
_version_ | 1783541122213085184 |
---|---|
author | Ahn, Jae-Min Oh, Hyuk-Jin Oh, Jae-Sang Yoon, Seok-Mann |
author_facet | Ahn, Jae-Min Oh, Hyuk-Jin Oh, Jae-Sang Yoon, Seok-Mann |
author_sort | Ahn, Jae-Min |
collection | PubMed |
description | BACKGROUND: Pituitary apoplexy is syndrome of sudden onset of headache, visual loss, pituitary dysfunction, and altered consciousness. Pituitary apoplexy followed by acute cerebral ischemia is extremely rare. Here, we introduced the case of successful surgical resection of pituitary adenoma which induced acute cerebral ischemia. CASE DESCRIPTION: A 78-year-old man with a known pituitary macroadenoma presented with decreased consciousness and left hemiparesis. Magnetic resonance image (MRI) and computed tomography (CT) showed large pituitary macroadenoma with hemorrhage and diffusion-perfusion mismatch of right internal carotid artery (ICA) territory. Conventional angiography was done and severe stenosis of bilateral ICA and prominent flow delay of left ICA were noted at paraclinoid segment. Microscopic tumor mass removal with transsphenoidal approach was performed. Final pathological diagnosis was pituitary adenoma with apoplexy. Immediately after surgery, his symptoms were disappeared. Follow-up image studies revealed much improved perfusion in right ICA territory and patency of bilateral ICAs. CONCLUSION: Direct compression of ICA is rare complication of pituitary apoplexy, which caused cerebral ischemia. Conventional angiography should be necessary for accurate diagnosis and prompt surgical decompression should be the treatment of choice. |
format | Online Article Text |
id | pubmed-7265385 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Scientific Scholar |
record_format | MEDLINE/PubMed |
spelling | pubmed-72653852020-06-02 Pituitary apoplexy causing acute ischemic stroke: Which treatment should be given priority Ahn, Jae-Min Oh, Hyuk-Jin Oh, Jae-Sang Yoon, Seok-Mann Surg Neurol Int Case Report BACKGROUND: Pituitary apoplexy is syndrome of sudden onset of headache, visual loss, pituitary dysfunction, and altered consciousness. Pituitary apoplexy followed by acute cerebral ischemia is extremely rare. Here, we introduced the case of successful surgical resection of pituitary adenoma which induced acute cerebral ischemia. CASE DESCRIPTION: A 78-year-old man with a known pituitary macroadenoma presented with decreased consciousness and left hemiparesis. Magnetic resonance image (MRI) and computed tomography (CT) showed large pituitary macroadenoma with hemorrhage and diffusion-perfusion mismatch of right internal carotid artery (ICA) territory. Conventional angiography was done and severe stenosis of bilateral ICA and prominent flow delay of left ICA were noted at paraclinoid segment. Microscopic tumor mass removal with transsphenoidal approach was performed. Final pathological diagnosis was pituitary adenoma with apoplexy. Immediately after surgery, his symptoms were disappeared. Follow-up image studies revealed much improved perfusion in right ICA territory and patency of bilateral ICAs. CONCLUSION: Direct compression of ICA is rare complication of pituitary apoplexy, which caused cerebral ischemia. Conventional angiography should be necessary for accurate diagnosis and prompt surgical decompression should be the treatment of choice. Scientific Scholar 2020-05-16 /pmc/articles/PMC7265385/ /pubmed/32494388 http://dx.doi.org/10.25259/SNI_82_2020 Text en Copyright: © 2020 Surgical Neurology International http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Case Report Ahn, Jae-Min Oh, Hyuk-Jin Oh, Jae-Sang Yoon, Seok-Mann Pituitary apoplexy causing acute ischemic stroke: Which treatment should be given priority |
title | Pituitary apoplexy causing acute ischemic stroke: Which treatment should be given priority |
title_full | Pituitary apoplexy causing acute ischemic stroke: Which treatment should be given priority |
title_fullStr | Pituitary apoplexy causing acute ischemic stroke: Which treatment should be given priority |
title_full_unstemmed | Pituitary apoplexy causing acute ischemic stroke: Which treatment should be given priority |
title_short | Pituitary apoplexy causing acute ischemic stroke: Which treatment should be given priority |
title_sort | pituitary apoplexy causing acute ischemic stroke: which treatment should be given priority |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7265385/ https://www.ncbi.nlm.nih.gov/pubmed/32494388 http://dx.doi.org/10.25259/SNI_82_2020 |
work_keys_str_mv | AT ahnjaemin pituitaryapoplexycausingacuteischemicstrokewhichtreatmentshouldbegivenpriority AT ohhyukjin pituitaryapoplexycausingacuteischemicstrokewhichtreatmentshouldbegivenpriority AT ohjaesang pituitaryapoplexycausingacuteischemicstrokewhichtreatmentshouldbegivenpriority AT yoonseokmann pituitaryapoplexycausingacuteischemicstrokewhichtreatmentshouldbegivenpriority |