Nakagawara J, Suematsu K, Nakamura J, Hotta T, Kamada H, Sasaki T, Hyogo T
No Shinkei Geka. 1985 Mar;13(3):307-11.
The association of pituitary adenoma and adjacent cerebral aneurysm is not uncommon and acute hemorrhage into a pituitary adenoma is also a well recognized condition. However, the simultaneous occurrence of pituitary apoplexy with intracranial aneurysm is very rare. Such a case demonstrates the diagnostic difficulty in distinguishing between pituitary apoplexy and rupture of an aneurysm. We reported a patient with subarachnoid hemorrhage in whom a hemorrhage into the pituitary adenoma and a carotid-ophthalmic aneurysm was proven, and discussed the differential diagnosis and treatment. A 41-year-old man, who developed sudden severe headache with nausea and vomiting, was admitted to our hospital. Examination disclosed a mildly stuporous man with bilateral defects of upper lateral visual fields and lumbar puncture revealed subarachnoid hemorrhage. Plain radiographs of the skull showed an enlarged and eroded sella turcica. Carotid angiography revealed a left carotid-ophthalmic aneurysm. A plain CT scan demonstrated an acute suprasellar hematoma. A transsphenoidal operation was performed and postoperative course was uneventful.
垂体腺瘤与相邻脑动脉瘤的关联并不罕见，垂体腺瘤内急性出血也是一种广为人知的情况。然而，垂体卒中与颅内动脉瘤同时发生极为罕见。这样的病例显示出区分垂体卒中和动脉瘤破裂的诊断困难。我们报告了一名蛛网膜下腔出血患者，经证实其垂体腺瘤和颈内动脉眼动脉瘤出血，并讨论了鉴别诊断和治疗方法。一名41岁男性，突发剧烈头痛伴恶心呕吐，入住我院。检查发现该男性轻度昏迷，双侧上外侧视野缺损，腰椎穿刺显示蛛网膜下腔出血。头颅平片显示蝶鞍扩大并被侵蚀。颈动脉血管造影显示左侧颈内动脉眼动脉瘤。普通CT扫描显示鞍上急性血肿。进行了经蝶窦手术，术后病程平稳。
