Case report: Ruptured internal carotid artery fusiform aneurysm mimicking pituitary apoplexy after stereotactic radiosurgery

Wang, Peng Wei; Chung, Ming Hsuan; Feng, Shao Wei; Liao, Haixing; Wu, Yi; Hueng, Dueng‐Yuan; Yang, Yun; Ju, Da‐Tong

doi:10.3389/fneur.2023.1219372

Cited by 2 publications

References 5 publications

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Correlation analysis of vertebral artery hemodynamic differences and clinical symptoms due to craniocervical junction abnormalities: based on computational fluid dynamics

Zhang,

Ai,

et al. 2024

Preprint

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Background and purpose Patients with craniocervical junction abnormalities (CJA) often exhibit vertebral artery (VA) abnormalities, and identifying these abnormalities can be beneficial for assessing patient symptoms and developing treatment plans. Material and Methods Sixty patients with CJA were admitted to our department from January 2018 to June 2022. Sixty healthy people were selected to undergo combined head and neck CTA, and the CTA images were imported into CFD-related software. The results were used to visualize and derive the lumen diameter (D), peak systolic velocity (PSV), mean blood flow velocity (MV), wall pressure (WP), wall shear stress (WSS) and other related data of vertebral arteries in different segments, and cross-sectional planes of the vertebral arteries at different segments were constructed to calculate the quantity of blood flow (Q) and the ratio of each index in each segment. The dizziness handicap inventory (DHI) was chosen to assess patient dizziness symptoms, and a multinomial logistic model was used to analyze the correlation between differences in vertebral artery hemodynamics due to patients with CJA and clinical symptoms such as dizziness. Results Compared with those in the control group, the mean DV3−V4, D\(\frac{\text{V}3-\text{V}4}{\text{V}1-\text{V}2}\)、QV3−V4、Q\(\frac{\text{V}3-\text{V}4}{\text{V}1-\text{V}2}\) of VA in the CJA group were significantly lower; the PSVV3−V4, PSV\(\frac{\text{V}3-\text{V}4}{\text{V}1-\text{V}2}\)、MVV1−V2、MVV3−V4、MV\(\frac{\text{V}3-\text{V}4}{\text{V}1-\text{V}2}\), WP and WSS in the CJA group were significantly greater; and the difference was statistically significant (P<0.05). According to the multinomial logistic regression analysis, for every 0.02 unit decrease in QV3−V4, the risk of increasing the DHI score to a higher grade increased by 40.49% compared with the original basis. Conclusions The V3-V4 segment of the vertebral artery in patients with CJA differs from that in the normal population in terms of hemodynamics, such as D, V, WP, and WSS, especially Q, and these differences lead to the occurrence of clinical symptoms such as dizziness and vertigo. The quantity of blood flow is negatively correlated with DHI, and age is positively correlated with DHI.

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Correlation analysis of vertebral artery hemodynamic differences and clinical symptoms due to craniocervical junction abnormalities: based on computational fluid dynamics

Zhang,

Ai,

et al. 2024

Preprint

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Pituitary Apoplexy: An Updated Review

Iglesias

2024

JCM

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Pituitary apoplexy (PA) is an acute, life-threatening clinical syndrome caused by hemorrhage and/or infarction of the pituitary gland. It is clinically characterized by the sudden onset of headache. Depending on the severity, it may also be accompanied by nausea, vomiting, visual disturbances, varying degrees of adenohypophyseal hormone deficiency, and decreased level of consciousness. Corticotropic axis involvement may result in severe hypotension and contribute to impaired level of consciousness. Precipitating factors are present in up to 30% of cases. PA may occur at any age and sometimes develops during pregnancy or the immediate postpartum period. PA occurs more frequently in men aged 50–60, being rare in children and adolescents. It can develop in healthy pituitary glands or those affected by inflammation, infection, or tumor. The main cause of PA is usually spontaneous hemorrhage or infarction of a pituitary adenoma (pituitary neuroendocrine tumor, PitNET). It is a medical emergency requiring immediate attention and, in many cases, urgent surgical intervention and long-term follow-up. Although the majority of patients (70%) require surgery, about one-third can be treated conservatively, mainly by monitoring fluid and electrolyte levels and using intravenous glucocorticoids. There are scoring systems for PA with implications for management and therapeutic outcomes that can help guide therapeutic decisions. Management of PA requires proper evaluation and long-term follow-up by a multidisciplinary team with expertise in pituitary pathology. The aim of the review is to summarize and update the most relevant aspects of the epidemiology, etiopathogenesis, pathophysiology, clinical presentation and clinical forms, diagnosis, therapeutic strategies, and prognosis of PA.

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Case report: Ruptured internal carotid artery fusiform aneurysm mimicking pituitary apoplexy after stereotactic radiosurgery

Cited by 2 publications

References 5 publications

Correlation analysis of vertebral artery hemodynamic differences and clinical symptoms due to craniocervical junction abnormalities: based on computational fluid dynamics

Correlation analysis of vertebral artery hemodynamic differences and clinical symptoms due to craniocervical junction abnormalities: based on computational fluid dynamics

Pituitary Apoplexy: An Updated Review

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