Stroke and carotid occlusion by giant non-hemorrhagic pituitary adenoma

Alentorn, Agustí; Bruna, Jordi; Acebes, J.J.; Velasco, Roser

doi:10.1007/s00701-011-1159-2

Cited by 9 publications

(8 citation statements)

References 7 publications

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“…In most patients, only unilateral intracranial vessels are compressed, however, bilateral ICA compromise was documented in five [3,4,12,17,19]. Three patients were found with symptomatic carotid obstruction secondary to compression of a gradually enlarging pituitary adenoma, supporting mechanical arterial compression as the mechanism of stroke [23][24][25].…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of pituitary apoplexy in association with hemispheric infarction

Zou

Liu

Sun

et al. 2015

Journal of Clinical Neuroscience

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Section: Discussionmentioning

confidence: 99%

Surgical treatment of pituitary apoplexy in association with hemispheric infarction

Zou

Liu

Sun

et al. 2015

Journal of Clinical Neuroscience

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“…Imaging demonstrated a large pituitary adenoma recurrence with clear occlusion of the encircled ICA; however, the primary tumor had been treated with subtotal resection followed by external beam radiation at 45 Gy approximately 32 years earlier, raising the possibility of radiation-induced arteriopathy as a contributor to the eventual infarct. 2 Cavalcanti and de Castro Júnior reported ICA stenosis in a newly diagnosed nonfunctioning pituitary adenoma, although in their case the finding may have been incidental, as the more pronounced vascular disease was ipsilateral to the hemiparesis. 7 Rey-Dios et al reported a case of left clinoid ICA stenosis caused by an enlarging pituitary adenoma, which presented subacutely with transient episodes of left hemispheric ischemia over several months, accompanied by bitemporal hemianopia.…”

Section: Internal Carotid Artery Compression Secondary To Pituitary Amentioning

confidence: 88%

“…Four prior cases of symptomatic ICA compression in the absence of pituitary apoplexy in any age group have been reported, occurring at an average age of 56 years. 2,7,34,39 Alentorn et al reported a case of recurrent pituitary tumor presenting with right paresis and aphasia. Imaging demonstrated a large pituitary adenoma recurrence with clear occlusion of the encircled ICA; however, the primary tumor had been treated with subtotal resection followed by external beam radiation at 45 Gy approximately 32 years earlier, raising the possibility of radiation-induced arteriopathy as a contributor to the eventual infarct.…”

Section: Internal Carotid Artery Compression Secondary To Pituitary Amentioning

confidence: 99%

Extraordinary case presentations in pediatric pituitary adenoma: report of 6 cases

Meyer¹,

Perry²,

Oushy³

et al. 2020

Journal of Neurosurgery: Pediatrics

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Pediatric pituitary adenomas (PPAs) are rare neoplasms with a propensity for unusual presentations and an aggressive clinical course. Here, the authors describe 6 highly atypical PPAs to highlight this tendency and discuss unexpected management challenges.A 14-year-old girl presented with acute hemiparesis and aphasia. MRI revealed a pituitary macroadenoma causing internal carotid artery invasion/obliteration without acute apoplexy, which was treated via emergent transsphenoidal resection (TSR). Another 14-year-old girl developed precocious galactorrhea due to macroprolactinoma, which was medically managed. Several years later, she re-presented with acute, severe, bitemporal hemianopia during her third trimester of pregnancy, requiring emergent induction of labor followed by TSR. A 13-year-old boy was incidentally diagnosed with a prolactinoma after routine orthodontic radiographs captured a subtly abnormal sella. An 18-year-old male self-diagnosed pituitary gigantism through a school report on pituitary disease. A 17-year-old boy was diagnosed with Cushing disease by his basketball coach, a former endocrinologist. A 12-year-old girl with growth arrest and weight gain was diagnosed with Cushing disease, which was initially treated via TSR but subsequently recurred and ultimately required 12 operations, 5 radiation treatments involving 3 modalities, bilateral adrenalectomy, and chemotherapy. Despite these efforts, she ultimately died from pituitary carcinoma.

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“…This result has shown that pituitary adenoma producing internal carotid artery occlusion was extremely rare. In literature review we have found five case reports describing pituitary tumors producing carotid artery occlusion without the presence of apoplectic events (10,(21)(22)(23)(24). Table 1 has summarized the details of these reports.…”

Section: Discussionmentioning

confidence: 99%

Symptomatic Occlusion of Internal Carotid Artery Caused by Pituitary Macro Adenoma Among the Patients Without Apoplectic Signs; Case Report and Review of the Literature

et al. 2016

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Introduction: Pituitary adenoma producing symptomatic carotid compression of the internal carotid artery without any apoplexy sign would be extremely rare and there was only one report regarding to this condition. Case Presentation: In this case report we have described a 57-year-old woman with a nonfunctional pituitary macro adenoma which has resulted to symptomatic internal carotid occlusion. Magnetic resonance imaging (MRI) revealed a large pituitary adenoma caused tight stenosis of right internal carotid. The patient has also experienced the transient ischemic attack which has confirmed to be the cause of internal carotid artery occlusion by this macro adenoma tumor. There was not any sign of apoplexy at the time of admission and the patient has not shown a history of pituitary adenoma. The patient then has undergone an endonasal transsphenoidal resection because of this nonfunctional pituitary adenoma. Conclusions: Pituitary macro adenoma producing symptomatic internal carotid occlusion might develop to several serious conditions including transient ischemic attack. Urgent surgical procedure might be the best approach to prevent further severe complications in such patients.

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Stroke and carotid occlusion by giant non-hemorrhagic pituitary adenoma

Cited by 9 publications

References 7 publications

Surgical treatment of pituitary apoplexy in association with hemispheric infarction

Surgical treatment of pituitary apoplexy in association with hemispheric infarction

Extraordinary case presentations in pediatric pituitary adenoma: report of 6 cases

Symptomatic Occlusion of Internal Carotid Artery Caused by Pituitary Macro Adenoma Among the Patients Without Apoplectic Signs; Case Report and Review of the Literature

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