Department of Medicine and Division of Endocrinology, Maulana Azad Medical College, Bahadur Shah Zafar Marg, New Delhi, India.
Pituitary. 2011 Dec;14(4):384-7. doi: 10.1007/s11102-009-0179-x. Epub 2009 Apr 19.
Optic chiasmal herniation following dopamine agonist therapy is a rare complication in patients with giant prolactinomas. But there are a few case reports of brain and chiasmal herniation following medical therapy in such cases. We report a young man who developed secondary visual loss and seizures after 6 months of medical treatment with cabergoline for giant prolactinoma. Magnetic resonance imaging of hypothalamic pituitary region revealed optic chiasmal and frontal lobe herniation into sella. There was marginal improvement in his vision after cabergoline dose reduction. The present case report highlights frontal lobe herniation in conjunction with optic chiasmal herniation as a very rare complication of medical therapy of giant prolactinoma. Different treatment options of this condition are being discussed.
多巴胺激动剂治疗后出现视交叉疝是巨大泌乳素瘤患者的一种罕见并发症。但也有少数病例报告称，在这种情况下，药物治疗后会出现脑疝和视交叉疝。我们报告了一例年轻男性，在使用卡麦角林治疗巨大泌乳素瘤 6 个月后出现继发性视力丧失和癫痫发作。下丘脑-垂体区域的磁共振成像显示视交叉和额叶疝入蝶鞍。卡麦角林剂量减少后，他的视力略有改善。本病例报告强调了额叶疝与视交叉疝一起作为巨大泌乳素瘤药物治疗的一种非常罕见的并发症。目前正在讨论这种情况的不同治疗选择。
