Takasugi N, Doi A
Neurol Med Chir (Tokyo). 1989 Oct;29(10):908-11. doi: 10.2176/nmc.29.908.
A case of pituitary apoplexy causing pituitary hemorrhage with extension into the third ventricle is reported. The patient was a 73-year-old, obese female admitted with sudden onset of vomiting and impaired consciousness. Neurological examination revealed that she was stuporous, with marked neck stiffness and a dilated left pupil. A plain skull X-ray showed sellar enlargement and destruction of the dorsum sellae. Computed tomography demonstrated a high-density area in the third and lateral ventricles and a round, high-density mass in the suprasellar cistern. The patient died the next day. Autopsy revealed a large tumor in the sellar and suprasellar areas. The tumor and the hematoma within it compressed the floor of the third ventricle and passed through the lamina terminalis and the hypothalamic region. Histological examination disclosed a basophilic adenoma. The pituitary hemorrhage appeared to be the result of ischemia and necrosis within the pituitary adenoma caused by its acute expansion. The extension of the hematoma into the third ventricle was attributable to the large size of the tumor and its close adhesion to the floor of third ventricle.
报告了一例垂体卒中导致垂体出血并扩展至第三脑室的病例。患者为一名73岁的肥胖女性，因突发呕吐和意识障碍入院。神经系统检查发现她处于昏迷状态，颈部明显僵硬，左侧瞳孔散大。头颅X线平片显示蝶鞍扩大及鞍背破坏。计算机断层扫描显示第三脑室和侧脑室内有高密度区，鞍上池有一个圆形高密度肿块。患者于次日死亡。尸检发现蝶鞍和鞍上区域有一个大肿瘤。肿瘤及其内的血肿压迫第三脑室底部，并穿过终板和下丘脑区域。组织学检查显示为嗜碱性腺瘤。垂体出血似乎是垂体腺瘤急性扩张导致其内部缺血坏死的结果。血肿扩展至第三脑室可归因于肿瘤体积大及其与第三脑室底部紧密粘连。
