Turkish Neurosurgery 2014 , Vol 24 , Num 5
Cerebral Infarction Caused by Pituitary Apoplexy: Case Report and Review of Literature
Chenxi ZHANG1, Feng FENG2, Yicheng ZHU3, Renzhi WANG1, Bing XING1
1Peking Union Medical College Hospital, Departments of Neurosurgery, Beijing, China
2Chinese Academy of Medical Sciences, Departments of Radiology, Beijing, China
3Peking Union Medical College, Departments of Neurology, Beijing, China
DOI : 10.5137/1019-5149.JTN.9237-13.0 Pituitary apoplexy followed by cerebral infarction is rare. In this report, we present a 42-year-old man who had been diagnosed of pituitary adenoma presented with a sudden onset of unconsciousness, left hemiplegia and right ptosis. Investigations revealed the development of pituitary apoplexy. The extension of tumor mass compressed the supraclinoid portion of the right internal carotid artery, resulting in the cerebral infarction in the right anterior and middle cerebral artery territory. Left anterior cerebral artery territory infarction was also found, which could be caused by vasospasm provoked by pituitary apoplexy. The patient underwent decompression surgery via transsphenoidal approach after four weeks’ conservative treatment, and pathological examination revealed hemorrhage and necrosis of the pituitary adenoma. His symptoms improved within five months’ follow-up. Since pituitary apoplexy producing cerebral infarction is rare, clinicians should be alert to that possibility, and delayed transsphenoidal surgery following conservative management with steroids is the appropriate management of such an occurrence. Keywords : Cerebral infarction, Compression, Internal carotid artery, Pituitary apoplexy, Vasospasm
Corresponding author : Bing Xřng, xingbingemail@aliyun.com