A 37-year-old man presented with perimesencephalic non-aneurysmal subarachnoid hemorrhage associated with cavernous sinus thrombosis. Anticoagulant therapy was administered to treat the cavernous sinus thrombosis, but provoked severe intracranial hemorrhage, severely disabling the patient. Perimesencephalic non-aneurysmal subarachnoid hemorrhage is a benign clinical entity with generally good prognosis, but the association with cavernous sinus thrombosis requires careful investigation prior to treatment.
Over a 16-year period, 105 patients with pituitary adenoma accompanied by visual disturbance under went transcranial intracapsular removal of the tumor followed by radiotherapy. Postoperative recov ery of visual function in these patients was compared with the results obtained in other institutions after trans-sphenoidal surgery. The severity of preoperative visual impairment was correlated with the duration of visual impairment, the degree of optic atrophy, the extent of suprasellar tumor infil tration, and age. Trans-sphenoidal surgery appears more effective in patients with mild preoperative visual disturbance, whereas the transcranial approach yields better results in patients with moderate to severe preoperative visual deficits.
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