Mathur D, Lim L F M, Mathur M, Sng B L
Department of Women's Anaesthesia, KK Women's and Children's Hospital, Singapore.
Anaesth Intensive Care. 2014 Jan;42(1):99-105. doi: 10.1177/0310057X1404200118.
Pituitary apoplexy is a rare condition involving pituitary necrosis following either pituitary haemorrhage or infarction. Similarly, reversible cerebral vasoconstrictive syndrome is a cerebrovascular disorder characterised by diffuse, multifocal narrowing of cerebral arteries. Both may present with an acute, intense headache and associated neurological deficits. In postpartum women, these conditions should be considered in the differential diagnosis of post-dural puncture headache following regional anaesthesia, as serious morbidity may ensue if they are left untreated. We report the case of a patient who developed pituitary apoplexy during an emergency caesarean section under spinal anaesthesia. It was further complicated by the development of reversible cerebral vasoconstriction syndrome and stroke.
垂体卒中是一种罕见的病症，涉及垂体出血或梗死后的垂体坏死。同样，可逆性脑血管收缩综合征是一种脑血管疾病，其特征是脑动脉弥漫性、多灶性狭窄。两者都可能表现为急性剧烈头痛及相关神经功能缺损。在产后女性中，区域麻醉后发生硬膜穿刺后头痛的鉴别诊断应考虑这些病症，因为如果不治疗可能会导致严重的发病率。我们报告一例在脊髓麻醉下行急诊剖宫产时发生垂体卒中的患者。该病例进一步并发了可逆性脑血管收缩综合征和中风。
