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一例与龋齿相关的垂体脓肿和多发性脑颅内动脉瘤病例。

A Case of Pituitary Abscess and Multiple Cerebral Intracranial Aneurysms Related to Dental Caries.

作者信息

Ikuta Genki, Kaku Yasuyuki, Shinojima Naoki, Mizuno Takamasa, Mukasa Akitake

机构信息

Department of Neurosurgery, Kumamoto University Hospital, Kumamoto, JPN.

Department of Neurosurgery, Ariake Medical Center, Kumamoto, JPN.

出版信息

Cureus. 2025 Jul 11;17(7):e87708. doi: 10.7759/cureus.87708. eCollection 2025 Jul.

Abstract

We report a rare case of a 60-year-old woman who initially presented with subarachnoid hemorrhage and was later diagnosed with a pituitary abscess 11 months after coil embolization. Poor oral hygiene and cultures positive for () from both the throat and pituitary abscess pus suggested that the infection had a dental origin. Because of the rarity of aneurysms with atypical morphology and location, the previously treated multiple intracranial aneurysms-including an anterior communicating artery aneurysm, a true posterior communicating artery aneurysm, and an anterior wall aneurysm of the internal carotid artery-were retrospectively suspected to be infectious. Because infectious aneurysms of the anterior communicating artery are exceptionally uncommon, we reviewed similar reported cases. This case highlights the potential for dental infections to cause serious central nervous system complications. Clinicians should maintain a high index of suspicion for pituitary abscess and the possibility of infectious aneurysms when encountering multiple aneurysms with atypical morphology or location, particularly in patients with poor oral hygiene or a suspected Rathke's cleft cyst.

摘要

我们报告了一例罕见病例,一名60岁女性最初表现为蛛网膜下腔出血,在弹簧圈栓塞术后11个月被诊断为垂体脓肿。口腔卫生差,咽喉部和垂体脓肿脓液培养出()阳性,提示感染源自牙齿。由于非典型形态和位置的动脉瘤罕见,既往治疗的多个颅内动脉瘤——包括前交通动脉瘤、真正的后交通动脉瘤和颈内动脉前壁动脉瘤——经回顾性分析怀疑为感染性动脉瘤。由于前交通动脉感染性动脉瘤极为罕见,我们回顾了类似的报道病例。该病例凸显了牙齿感染导致严重中枢神经系统并发症的可能性。临床医生在遇到形态或位置非典型的多个动脉瘤时,尤其是口腔卫生差或疑似拉克氏裂囊肿的患者,应高度怀疑垂体脓肿和感染性动脉瘤的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/405f/12335880/220c2f9f730a/cureus-0017-00000087708-i01.jpg

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