Castro-Castro J, Torre-Eiriz J A, Pinzón-Millán A, Pastor-Zapata A
Servicios de Neurocirugía, Complejo Hospitalario de Ourense, Ourense, España.
Neurocirugia (Astur). 2011 Dec;22(6):558-61; discussion 561. doi: 10.1016/s1130-1473(11)70110-5.
Treatment of patients with prolactinomas consists primarily of dopamine agonists (DA). When these drugs reduce the size of invasive prolactinomas, the intra- and extra-cranial spaces may be communicated. Pneumocephalus and cerebrospinal fluid leakage have been reported. A 56 year old male was admitted to the emergency unit with an intracranial hypertension syndrome. He had been treated for 2 weeks with cabergoline after an invasive prolactinoma was discovered. Brain CT showed frontal interhemispheric pneumocephalus on the previous tumor cavity, and bony defect on the sellar floor. Evacuation of pneumocephalus, reparation of cranial and meningeal defects and subtotal tumor removal were performed. The literature is reviewed looking for possible pathophysiological mechanism, prevention and treatment.
泌乳素瘤患者的治疗主要包括使用多巴胺激动剂（DA）。当这些药物使侵袭性泌乳素瘤体积缩小时，颅内和颅外间隙可能相通。已有气颅和脑脊液漏的报道。一名56岁男性因颅内高压综合征入住急诊病房。他在发现侵袭性泌乳素瘤后已用卡麦角林治疗2周。脑部CT显示先前肿瘤腔处有额部半球间气颅，蝶鞍底部有骨质缺损。进行了气颅引流、颅骨和脑膜缺损修复以及肿瘤次全切除。本文回顾了相关文献以寻找可能的病理生理机制、预防和治疗方法。
