Kobayashi S, Otsuka A, Tsunoda T
Department of Neurosurgery, Kumagaya General Hospital, Saitama.
Neurol Med Chir (Tokyo). 1996 Jul;36(7):451-4. doi: 10.2176/nmc.36.451.
A 46-year-old male presented with acute visual loss in the right eye, high fever, nausea, and vomiting. This was caused by herniation of the third ventricle into empty sella at 15 months of surgery for pituitary apoplexy. The sellar-suprasellar tumor was totally removed via a transcranial approach. Histological examination showed chromophobe adenoma with necrotic tissue, indicating pituitary apoplexy. His visual field defect worsened 15 months after the operation, and magnetic resonance imaging revealed moderate hydrocephalus and protrusion of the dilated anterior inferior portion of the third ventricle into the sella. The optic nerve, optic chiasm, and pituitary gland were compressed onto the sellar floor. Ventriculoperitoneal shunt relieved the visual impairment. A decompressive procedure such as ventriculoperitoneal shunts is a reasonable treatment for such a marked herniation of the third ventricle.
一名46岁男性出现右眼急性视力丧失、高热、恶心和呕吐。这是由于垂体卒中手术后15个月第三脑室疝入空蝶鞍所致。经颅入路将鞍区-鞍上肿瘤完全切除。组织学检查显示嫌色性腺瘤伴坏死组织，提示垂体卒中。术后15个月他的视野缺损加重，磁共振成像显示中度脑积水以及第三脑室扩张的前下部突入蝶鞍。视神经、视交叉和垂体被挤压到蝶鞍底部。脑室腹腔分流术缓解了视力损害。对于如此明显的第三脑室疝，脑室腹腔分流术等减压手术是一种合理的治疗方法。
