Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
World Neurosurg. 2018 Feb;110:101-105. doi: 10.1016/j.wneu.2017.10.163. Epub 2017 Nov 6.
Cushing disease, induced by a pituitary adrenocorticotropic hormone (ACTH)-secreting adenoma, is associated with high risk of stroke. At present, transsphenoidal surgery remains the first line of therapy. Cerebral venous sinus thrombosis (CVST) is an uncommon form of stroke with variable presentations. There are no previous reports of its occurrence in patients with Cushing disease following transsphenoidal surgery.
We report a patient with Cushing disease who sustained CVST several days after a second transsphenoidal surgery. With adequate care and treatment, along with timely diagnosis, the patient made a near-complete recovery with only minor sequelae.
In view of the poor outcome of untreated CVST, symptoms such as severe headache, nausea and vomiting, and cerebrospinal fluid leakage after transsphenoidal surgery could be of valuable assistance in early diagnosis, allowing immediate medical intervention with consequent improved prognosis.
由垂体促肾上腺皮质激素（ACTH）分泌腺瘤引起的库欣病与中风风险增加有关。目前，经蝶窦手术仍然是一线治疗方法。脑静脉窦血栓形成（CVST）是一种少见的中风形式，表现多样。以前没有报道过库欣病患者在经蝶窦手术后发生 CVST。
我们报告了一例库欣病患者，在第二次经蝶窦手术后数天发生 CVST。经过适当的护理和治疗，以及及时的诊断，患者几乎完全康复，只有轻微的后遗症。
鉴于未经治疗的 CVST 预后不良，如果在经蝶窦手术后出现严重头痛、恶心和呕吐以及脑脊液漏等症状，可能有助于早期诊断，从而立即进行医疗干预，改善预后。
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