Picón Jaimes Yelson Alejandro, Orozco Chinome Javier Esteban, López Cepeda Daniela, Quintana Pájaro Loraine, Galindo-Velásquez Hather, Ramos-Villegas Yancarlos, Ripoll-Zapata Vanessa, Morales-Núñez María Angélica, Moscote Salazar Luis Rafael
Universidad Pedro de Valdivia.
Asociación Chilena de Seguridad, Santiago de Chile.
Rev Fac Cien Med Univ Nac Cordoba. 2022 Jun 6;79(2):141-145. doi: 10.31053/1853.0605.v79.n2.27984.
Necrosis or hemorrhage associated with pituitary tumors is an infrequent complication. The term pituitary apoplexy is related to the development of an inflammatory process that leads to irritation of the meningeal and periselar areas. Regardless of the mechanism (hemorrhage or infarction), the extent of the hemorrhage and necrosis will produce an increase in intraselar pressure which, in turn, will lead to a more or less pronounced compression of neighboring structures, thus explaining the broad spectrum clinical.
We carried out a systematic review of cases published internationally. The analysis of 8 cases published in the literature was carried out, 5 cases in the male pediatric population (62.5%), and 3 cases of the female gender (37.5%).
The mean age was 12.8 years (SD ± 2.5). The clinical manifestations included: headache, impaired vision, nausea and vomiting, fever, cranial nerve involvement, and, to a lesser extent, compromise of consciousness. Seventy-five percent (n = 6) of the patients had a headache, 16.6% had a frontal location, 16.6% accompanied by retroorbital pain, and 66.6% did not specify the location. On the other hand, only 37.5% of the patients had nausea and/or vomiting. While 25% were admitted with fever and 12.5% (n = 1) had changes in the state of consciousness.
Pituitary apoplexy is a pathology that requires a multidisciplinary approach at the pediatric level. Management directed by pediatric neurosurgery and endocrinology will allow us to offer our patients the best, evidence-based treatment available.
垂体肿瘤相关的坏死或出血是一种罕见的并发症。垂体卒中这一术语与炎症过程的发展有关，该炎症过程会导致脑膜和鞍周区域受到刺激。无论其机制是出血还是梗死，出血和坏死的程度都会导致鞍内压力升高，进而或多或少地导致邻近结构受到明显压迫，从而解释了其广泛的临床症状。
我们对国际上发表的病例进行了系统综述。对文献中发表的8例病例进行了分析，其中5例为男性儿童患者（62.5%），3例为女性患者（37.5%）。
平均年龄为12.8岁（标准差±2.5）。临床表现包括：头痛、视力障碍、恶心呕吐、发热、颅神经受累，意识障碍的情况较少。75%（n = 6）的患者有头痛症状，其中16.6%为额部头痛，16.6%伴有眶后疼痛，66.6%未明确头痛部位。另一方面，只有37.5%的患者有恶心和/或呕吐症状。25%的患者入院时伴有发热，12.5%（n = 1）有意识状态改变。
垂体卒中是一种在儿科需要多学科治疗的疾病。由小儿神经外科和内分泌科主导的治疗将使我们能够为患者提供最佳的循证治疗。
