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[1例轻度头部外伤后出现严重意识障碍的垂体卒中]

[A case of pituitary apoplexy with severe consciousness disturbance following mild head trauma].

作者信息

Horie Nobutaka, Tokunaga Yoshiharu, Takahashi Nobuaki, Furuichi Shoji, Mori Katsuharu, Shibata Shoubu

机构信息

Department of Neurosurgery, Fukuoka Kinen Hospital, Fukuoka.

出版信息

No To Shinkei. 2002 Aug;54(8):697-701.

Abstract

A rare case of pituitary apoplexy following mild head trauma is reported. A 56-year-old woman was referred to our hospital for loss of consciousness following a traffic accident. Magnetic resonance (MR) imaging showed a large suprasellar tumor containing a low intensity area on the T 1-, T 2-weighted images and fluid-attenuated inversion recovery (FLAIR) image. These findings indicated fresh intratumoral hemorrhage. The tumor extended to the suprasellar region and put pressure on the hypothalamus and brain stem. The tumor, with marked intratumoral hemorrhage, was resected with an emergency right front-temporal craniotomy. And the patient was left severely disabled. The tumor histology was diffuse-type pituitary adenoma. In our case, we suggest that the cause of pituitary apoplexy following head trauma was shearing stress between the intra- and suprasellar part of the easy bleeding tumor, or direct injury by bone structure such as teberculum sellae, dorsum sellae, or anterior clinoid process.

摘要

报告了一例轻度头部外伤后发生垂体卒中的罕见病例。一名56岁女性因交通事故后意识丧失被转诊至我院。磁共振(MR)成像显示鞍上有一个大肿瘤,在T1加权、T2加权图像及液体衰减反转恢复(FLAIR)图像上有低强度区域。这些发现提示肿瘤内有新鲜出血。肿瘤延伸至鞍上区域,压迫下丘脑和脑干。该伴有明显肿瘤内出血的肿瘤通过急诊右额颞开颅手术切除。患者遗留严重残疾。肿瘤组织学检查为弥漫型垂体腺瘤。在我们的病例中,我们认为头部外伤后垂体卒中的原因是易出血肿瘤鞍内和鞍上部分之间的剪切力,或蝶鞍结节、鞍背或前床突等骨结构的直接损伤。

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