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内镜经鼻蝶窦垂体大腺瘤手术后,因假性动脉瘤引起的血管痉挛表现不典型。

Unusual Presentation of Vasospasm Masking Underlying Pseudoaneurysm After Endoscopic Transsphenoidal Surgery in Pituitary Macroadenoma.

机构信息

Department of Neurosurgery, PGIMER, Chandigarh, India.

Department of Neurosurgery, PGIMER, Chandigarh, India.

出版信息

World Neurosurg. 2019 Nov;131:163-165. doi: 10.1016/j.wneu.2019.07.176. Epub 2019 Jul 31.

Abstract

BACKGROUND

Vascular complications during transsphenoidal surgery can be devastating. Direct vascular injury during surgery can lead to various complications including pseudoaneurysm formation. Postoperative hematoma and direct vascular handling due to arachnoid tear can induce vasospasm. The vasospasm might present with varying clinical symptomatology and at times masks the underlying pathology as well.

CASE DESCRIPTION

We present here a case of pituitary macroadenoma in whom the vasospasm caused vision loss and also concealed a developing pseudoaneurysm.

CONCLUSIONS

Angiograms at regular intervals should be performed in cases where intraoperative vascular injury is suspected to detect such aneurysms and prevent catastrophe.

摘要

背景

经蝶窦手术期间的血管并发症可能是毁灭性的。手术过程中的直接血管损伤可导致各种并发症,包括假性动脉瘤形成。术后血肿和蛛网膜撕裂引起的直接血管处理可诱发血管痉挛。血管痉挛可能表现出不同的临床症状,有时也会掩盖潜在的病理。

病例描述

我们在此介绍一例垂体大腺瘤患者,其血管痉挛导致视力丧失,并掩盖了正在形成的假性动脉瘤。

结论

对于术中怀疑有血管损伤的病例,应定期进行血管造影,以发现此类动脉瘤并预防灾难发生。

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