与垂体卒中相关的罕见双侧额叶脑梗死。一种不常见的表现及文献综述。
Unusual bifrontal cerebral infarction related to pituitary apoplexy. An uncommon presentation and literature review.
作者信息
Holanda Tiago S F, Pimentel Isnara Mara Freitas, Araujo Paulo Victor Ferreira Gomes, da Silva Damasceno Gomes José Ítalo, de Morais Moreira Vinícius Chagas, Soares Tito Bastos Siqueira, de Albuquerque Lucas Alverne Freitas
机构信息
Department of Neurosurgery, General Hospital of Fortaleza, Fortaleza, Brazil.
Department of Otorhinolaryngology, Leonardo da Vinci Hospital, Fortaleza, Brazil.
出版信息
Surg Neurol Int. 2022 Dec 9;13:577. doi: 10.25259/SNI_979_2022. eCollection 2022.
BACKGROUND
Pituitary apoplexy (PA) is a syndromic condition described in 1950. The main symptoms are headache, visual impairment, ophthalmoplegia, and hypopituitarism. The relationship between stroke and PA is uncommon and two mechanisms are described: vascular compression and vasospasm.
CASE REPORT
A 65-old-year man presented with severe headache, vomiting, ophthalmoplegia, and somnolence. Radiological examinations showed an expansive sellar and suprasellar lesion with a heterogeneous signal, besides Diffusion-weighted imaging (DWI) restriction in the bifrontal area was present. The findings were compatible with PA and stroke.
CONCLUSION
PA leading to cerebral infarction is a rare condition that presents high morbidity and mortality levels. There are two main mechanisms related: direct arterial compression and arterial vasospasm. The cases must be conducted as neuroendocrinological emergencies and surgical management is a key point to better the prognosis of patients.
背景
垂体卒中（PA）是1950年描述的一种综合征。主要症状为头痛、视力障碍、眼肌麻痹和垂体功能减退。卒中与PA之间的关系并不常见，有两种机制：血管压迫和血管痉挛。
病例报告
一名65岁男性出现严重头痛、呕吐、眼肌麻痹和嗜睡。影像学检查显示鞍区和鞍上区有一个膨胀性病变，信号不均匀，此外双侧额叶区域存在弥散加权成像（DWI）受限。这些发现与PA和卒中相符。
结论
PA导致脑梗死是一种罕见的疾病，具有高发病率和死亡率。有两种主要相关机制：直接动脉压迫和动脉血管痉挛。这些病例必须作为神经内分泌急症来处理，手术治疗是改善患者预后的关键。
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