Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore, 119228, Singapore.
Pituitary. 2014 Apr;17(2):171-9. doi: 10.1007/s11102-013-0485-1.
Vasospasm and consequent cerebral ischaemia in aneurysmal subarachnoid haemorrhage are well-described. The development of cerebral ischaemia following pituitary tumour surgery is under-appreciated, and can be attributed to mainly cerebral vasospasm or internal carotid artery compression. We report on two patients with pituitary tumours who developed delayed cerebral ischaemia after transsphenoidal and transcranial pituitary macroadenoma decompression. The patients had vasospasm of intracranial vessels demonstrable on magnetic resonance angiogram. One recovered neurologically following nimodipine and hypertensive-hypervolaemia therapy while the other developed fulminant cerebral infarction. We discuss the complex multi-factorial mechanisms of cerebral ischaemia in pituitary disorders, as well as the management strategies and their limitations.
颅内血管磁共振血管造影显示存在血管痉挛。其中 1 例患者经尼莫地平及高血压高血容量治疗后神经功能恢复，另 1 例患者则出现暴发性脑梗死。我们讨论了垂体疾病中脑缺血的复杂多因素机制，以及治疗策略及其局限性。
