Acute hemorrhage into pituitary adenoma with SAH and anterior cerebral artery occlusion

Majchrzak, H; Wencel, T; Dragan, Tadeusz; Białas, J

doi:10.3171/jns.1983.58.5.0771

Cited by 32 publications

(16 citation statements)

References 14 publications

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“…Therefore, we speculate that the internal carotid artery was easy to displace and was occluded by the acute enlarged suprasellar mass infiltrating directly to the cavernous sinus. Massive cerebral infarction following mechanical compression of the internal carotid artery is known 1,3,7,8,[11][12][13][14] (Table 1). The internal carotid artery was occluded in the cavernous sinus or supraclinoid portion by the enlarged tumor in most cases.…”

Section: Discussionmentioning

confidence: 99%

Pituitary Apoplexy Causing Internal Carotid Artery Occlusion -Case Report-

Chokyu

Tsuyuguchi

Goto

et al. 2011

Neurol. Med. Chir.(Tokyo)

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A 50-year-old man presented with pituitary apoplexy resulting in internal carotid artery occlusion manifesting as sudden onset of severe headache, right ptosis, and left hemiparesis, associated with visual impairment. Computed tomography showed a nodular mass, located in the sellar and suprasellar regions with early signs of acute cerebral ischemia. Magnetic resonance (MR) imaging indicated that the mass compressed the bilateral cavernous sinuses, resulting in obliteration of the cavernous portion of the right internal carotid artery. Right middle cerebral artery territory infarction was also found. Conservative therapy with steroids was given in the acute stage and repeated MR imaging showed recanalization of the internal carotid artery with reduction of the tumor size. The tumor was removed through the transsphenoidal approach to obtain a definitive diagnosis in the chronic stage. The histological diagnosis was consistent with non-functioning pituitary adenoma. Eye movement of this patient showed full recovery after the operation. Pituitary apoplexy resulting in internal carotid artery occlusion is rare. Surgical decompression through the transsphenoidal approach is appropriate, but the optimal timing should consider severe disturbance of visual acuity and visual field in the acute stage.

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Section: Discussionmentioning

confidence: 99%

Pituitary Apoplexy Causing Internal Carotid Artery Occlusion -Case Report-

Chokyu

Tsuyuguchi

Goto

et al. 2011

Neurol. Med. Chir.(Tokyo)

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“…ACA notching may also represent a potential concomitant risk of cerebral infarction, which has not been addressed in previous reports, though rare cases of cerebral infarction in the ACA area following pituitary apoplexy have been reported [8,9]. Akutsu et al [9 ]presented a case of pituitary apoplexy complicated by cerebral infarction in the areas of Heubner’s artery and perforators arising from the A1 segment.…”

Section: Discussionmentioning

confidence: 99%

Anterior Cerebral Artery Notching on Anterior Optic Pathways in a Child with Craniopharyngioma and Progressive Blindness

Yokota

Yokoyama²,

Nishioka³

et al. 2011

Pediatr Neurosurg

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We report the clinical significance of anterior cerebral artery (ACA) notching on the optic nerve and chiasm in a 3.5-year-old girl with a craniopharyngioma and progressive blindness. She presented with a headache and vomiting, followed by binocular blindness. Magnetic resonance imaging (MRI) studies demonstrated severely distended A1 segments and ill-depicted ACAs. Surgical decompression via a right subfrontal approach was performed to reverse blindness. Postoperative MRI studies showed good ACA visualization. A second operation via a right pterional approach revealed ACA notching, which appeared as a transverse groove on the right optic nerve and chiasm. ACA notching should be considered as a possible cause of progressive visual disturbance and a potential risk of ACA infarction in a child with a craniopharyngioma.

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“…Aproximadamente 17% dos tumores pituitáríos removidos cirurgicamente mostram evidências histológicas de infartos e aproximadamente 7% de todos os pacientes com adenomas pituitáríos desenvolvem apoplexia 2 -3 , que geralmente se associa com aumento agudo da massa tumoral, devido ao infarto ou hemorragia 1,5 . Os mecanismos propostos nas obstruções da artéria carótida interna por adenomas pituitáríos podem ser divididos em 3 tipos 4 -7 : 1. obstrução como resultado do rápido crescimento tumoral; 2. obstrução causada por vaso-espasmo devido ao extravazamento de sangue no espaço subaracnóideo; 3. envolvimento de agentes vaso-ativos.…”

Section: Discussionunclassified

Macroadenoma pituitário não hemorrágico produzindo oclusão reversível de artéria carótida interna: a respeito de um caso

Cavalcanti

Júnior

1997

Arq. Neuro-Psiquiatr.

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RESUMO -Os autores relatam o caso de uma paciente com macroadenoma pituitário não hemorrágico produzindo oclusão reversível de artéria carótida interna. A obstrução da artéria carótida interna por tumor pituitário é rara, particularmente na ausência de apoplexia hipofisária. A correlação neurorradiológica torna-se de fundamental importância para demonstrar a oclusão completa ou trombose do vaso afetado. O completo restabelecimento pós-cirúrgico do fluxo sangüíneo da artéria carótida interna torna-se imperativo para a completa regressão sintomatológica.PALAVRAS-CHAVE: angiografia carotidea, artéria carótida interna, neuroimagem, adenoma pituitário, apoplexia pituitária, cirurgia transesfenoidal, obstrução vascular. Non-hemorragic pituitary macroadenoma producing reversible internal carotid artery occlusion: case reportAbstract -The case of woman with diagnosis on non-hemorragic pituitary macroadenoma producing reversible occlusion of the internal carotid artery is presented. The obstruction of the internal carotid artery by a pituitary tumor is rare, particularly in the absence of hypophyseal apoplexy. The neuroradiological correlation becomes fundamentally important to demonstrate the complete occlusion or thrombosis of the affected vessel. The complete restablishment of blood flow of the internal carotid artery after surgery becomes imperative for the complete symptomatological regression.KEY WORDS: carotid angiography, internal carotid artery, neuroimaging, pituitary adenoma, pituitary apoplexy, transesphenoidal surgery, vascular obstruction.Desde a descrição inicial por Blebtren, em 1905, de hemorragia em um adenoma pituitário, surgiram na litratura vários trabalhos, principalmente a respeito de apoplexia pituitária produzindo oclusão de artéria carótida interna e fenomenologia isquêmica. Muitos fatores precipitantes estão incluídos sendo os principais: trauma, radioterapia, terapia anticoagulante, tratamento estrogênico e com bromocriptina. Os sinais e sintomas usuais de apoplexia pituitária incluem cefaléia, alterações da consciência, náuseas, paralisia e/ou paresia de nervos extra-oculares, anormalidades pupilares e perda visual.Sinais de disfunção hemisférica cerebral focai são comuns nas obstruções de artéria carótida por apolexia pituitária. Os adenomas pituitários são os tumores mais freqüentemente encontrados na região selar e para-selar. A evolução de um tumor pituitário pode incluir hemorragia tumoral súbita ou necrose, como resultados de isquêmia. Somente em casos extremos e raros, os tumores pituitários causam oclusão dos vasos cerebrais, ocorrida às vezes no contexto de apoplexia.Relatamos o caso de uma paciente com macroadenoma pituitário não hemorrágico, produzindo oclusão reversível de artéria carótida interna. RELATO DO CASOAMA, paciente com 54 anos de idade, do sexo feminino, branca, doméstica, natural de São Luís -Maranhão, admitida em nosso serviço no Hospital do Centro Médico-Maranhense, queixandoServiço de Neurologia e Neurocirurgia do Centro Médico-Maranhanse: *Neurocirurgião, Chefe do ...

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Acute hemorrhage into pituitary adenoma with SAH and anterior cerebral artery occlusion

Cited by 32 publications

References 14 publications

Pituitary Apoplexy Causing Internal Carotid Artery Occlusion -Case Report-

Pituitary Apoplexy Causing Internal Carotid Artery Occlusion -Case Report-

Anterior Cerebral Artery Notching on Anterior Optic Pathways in a Child with Craniopharyngioma and Progressive Blindness

Macroadenoma pituitário não hemorrágico produzindo oclusão reversível de artéria carótida interna: a respeito de um caso

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