Ohtakara K, Matsubara T, Kojima T, Taki W, Waga S
Department of Neurosurgery, Mie University School of Medicine, Tsu, Japan.
Neurol Med Chir (Tokyo). 2000 Aug;40(8):413-8. doi: 10.2176/nmc.40.413.
An 80-year-old female presented with non-traumatic cerebrospinal fluid (CSF) rhinorrhea due to untreated prolactinoma, with simultaneous development of bilateral leg pains and gait disturbance due to lumbar canal stenosis. Neuroimaging showed an intrasellar mass extending into the sphenoid sinus, right cavernous sinus, and suprasellar cistern. Computed tomography cisternography clearly showed the CSF pathway through the tumor. Subtotal removal of the tumor and reconstruction of the sellar floor via a transsphenoidal approach resulted in resolution of the CSF rhinorrhea. Both the invasive features and/or spontaneous shrinkage of the tumor might have created the abnormal CSF pathway. The clinical manifestation of lumbar canal stenosis might be triggered by such profound CSF leakage.
一名80岁女性因未治疗的催乳素瘤出现非创伤性脑脊液鼻漏，同时因腰椎管狭窄出现双侧腿痛和步态障碍。神经影像学检查显示蝶鞍内肿块延伸至蝶窦、右侧海绵窦和鞍上池。计算机断层扫描脑池造影清楚地显示了脑脊液通过肿瘤的路径。经蝶窦入路次全切除肿瘤并重建鞍底，脑脊液鼻漏得以解决。肿瘤的侵袭性特征和/或自发缩小可能导致了异常的脑脊液通路。如此严重的脑脊液漏可能引发腰椎管狭窄的临床表现。
