Fernández-Real J M, Fernández-Castañer M, Villabona C, Sagarra E, Gómez-Sáez J M, Soler J
Department of Endocrinology, Ciutat Sanitària de Bellvitge, Barcelona, Spain.
Clin Investig. 1994 Mar;72(4):302-6. doi: 10.1007/BF00180045.
A 52-year-old woman was admitted to our hospital presenting with subarachnoid hemorrhage, left ophthalmoplegia, and right hemiparesis. Previous symptoms and signs suggested the presence of panhypopituitarism. A giant intracranial aneurysm of the internal carotid artery, diagnosed by magnetic resonance imaging, showed the characteristic flow void phenomenon with black appearance. Analysis of endocrine function disclosed panhypopituitarism and hyperprolactinemia. After proximal balloon occlusion of the aneurysm, diabetes insipidus developed. Pituitary function reassessed 6 months after initial admission confirmed anterior and posterior hypopituitarism and hyperprolactinemia. Possible mechanisms are discussed. A review of the literature on pituitary dysfunction caused by carotid artery aneurysms discloses that the pituitary-gonadal axis is the most frequently involved (67.5% of cases), followed by the pituitary-adrenal axis (48.6%) and the pituitary-thyroid axis (40.5%). These frequencies are very similar to those described in other types of hypopituitarism.
一名52岁女性因蛛网膜下腔出血、左侧动眼神经麻痹和右侧偏瘫入住我院。既往症状和体征提示存在全垂体功能减退。经磁共振成像诊断为颈内动脉巨大颅内动脉瘤，表现为典型的血流空洞现象，呈黑色外观。内分泌功能分析显示全垂体功能减退和高催乳素血症。动脉瘤近端球囊闭塞后，出现尿崩症。初次入院6个月后重新评估垂体功能，证实存在垂体前叶和后叶功能减退以及高催乳素血症。文中讨论了可能的机制。对颈动脉动脉瘤所致垂体功能障碍的文献综述显示，垂体-性腺轴受累最为常见（67.5%的病例），其次是垂体-肾上腺轴（48.6%）和垂体-甲状腺轴（40.5%）。这些频率与其他类型垂体功能减退中描述的频率非常相似。
