Pituitary apoplexy after cardiac surgery in a patient with subclinical pituitary adenoma: case report with review of literature

被引：0

作者：

Yakupoglu, Hakan ^{[1
]}

Onal, Mehmet Bulent ^{[1
]}

Civelek, Erdinc ^{[1
]}

Kircelli, Atilla ^{[2
]}

Celasun, Bulent ^{[3
]}

机构：

[1] Med Int Hosp, Dept Neurosurg, Ankara, Turkey

[2] Gulhane Mil Acad, Dept Neurosurg, Ankara, Turkey

[3] Med Int Hosp, Dept Pathol, Ankara, Turkey

来源：

NEUROLOGIA I NEUROCHIRURGIA POLSKA | 2010年 / 44卷 / 05期

关键词：

pituitary apoplexy; Sheehan's syndrome; cardiac surgery; pituitary adenoma; BYPASS-SURGERY; NERVE PALSY;

D O I：

暂无

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Pituitary adenoma infarction associated with cardiac surgery occurs rarely but it is a serious, life-threatening acute clinical event. Several mechanisms have been proposed but no direct cause has been clearly identified. We report a case of pituitary apoplexy occurring in a 74-year-old patient 6 hours after cardiac surgery The patient presented with confusion, unilateral ptosis and ophthalmoplegia. Neurological examination revealed right oculomotor nerve palsy and decreased level of consciousness. Magnetic resonance imaging showed a hemorrhagic and necrotic pituitary macroadenoma. After prompt endocrinological replacement therapy with hydrocortisone and levothyroxine, the confusion of the patient resolved. Removal of a non-functional macroadenoma with large necrotic areas resulted in full recovery The physician should be aware of pituitary adenoma infarction after open cardiac surgery and should remember that it can be fatal or cause permanent neurological or endocrine damage without proper treatment. Surgical and endocrine treatment can be life-saving procedures.

引用

页码：520 / 525

页数：6

共 22 条

[1]

ABSALOM M, 1993, ANESTH ANALG, V76, P648

[2] Pituitary apoplexy presenting as unilateral third cranial nerve palsy after coronary artery bypass surgery [J].