Pituitary Apoplexy Causing Internal Carotid Artery Occlusion: Case Report
A 50-year-old man presented with pituitary apoplexy resulting in internal carotid artery occlusion manifesting as sudden onset of severe headache, right ptosis, and left hemiparesis, associated with visual impairment. Computed tomography showed a nodular mass, located in the sellar and suprasellar r...
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| Veröffentlicht in: | Neurologia medico-chirurgica 2011, Vol.51(1), pp.48-51 |
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| container_title | Neurologia medico-chirurgica |
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| creator | CHOKYU, Isao TSUYUGUCHI, Naohiro GOTO, Takeo CHOKYU, Kimihiko CHOKYU, Masahiro OHATA, Kenji |
| description | A 50-year-old man presented with pituitary apoplexy resulting in internal carotid artery occlusion manifesting as sudden onset of severe headache, right ptosis, and left hemiparesis, associated with visual impairment. Computed tomography showed a nodular mass, located in the sellar and suprasellar regions with early signs of acute cerebral ischemia. Magnetic resonance (MR) imaging indicated that the mass compressed the bilateral cavernous sinuses, resulting in obliteration of the cavernous portion of the right internal carotid artery. Right middle cerebral artery territory infarction was also found. Conservative therapy with steroids was given in the acute stage and repeated MR imaging showed recanalization of the internal carotid artery with reduction of the tumor size. The tumor was removed through the transsphenoidal approach to obtain a definitive diagnosis in the chronic stage. The histological diagnosis was consistent with non-functioning pituitary adenoma. Eye movement of this patient showed full recovery after the operation. Pituitary apoplexy resulting in internal carotid artery occlusion is rare. Surgical decompression through the transsphenoidal approach is appropriate, but the optimal timing should consider severe disturbance of visual acuity and visual field in the acute stage. |
| doi_str_mv | 10.2176/nmc.51.48 |
| format | Article |
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Computed tomography showed a nodular mass, located in the sellar and suprasellar regions with early signs of acute cerebral ischemia. Magnetic resonance (MR) imaging indicated that the mass compressed the bilateral cavernous sinuses, resulting in obliteration of the cavernous portion of the right internal carotid artery. Right middle cerebral artery territory infarction was also found. Conservative therapy with steroids was given in the acute stage and repeated MR imaging showed recanalization of the internal carotid artery with reduction of the tumor size. The tumor was removed through the transsphenoidal approach to obtain a definitive diagnosis in the chronic stage. The histological diagnosis was consistent with non-functioning pituitary adenoma. Eye movement of this patient showed full recovery after the operation. Pituitary apoplexy resulting in internal carotid artery occlusion is rare. Surgical decompression through the transsphenoidal approach is appropriate, but the optimal timing should consider severe disturbance of visual acuity and visual field in the acute stage.</description><identifier>ISSN: 0470-8105</identifier><identifier>EISSN: 1349-8029</identifier><identifier>DOI: 10.2176/nmc.51.48</identifier><identifier>PMID: 21273745</identifier><language>eng</language><publisher>Japan: The Japan Neurosurgical Society</publisher><subject>Blepharoptosis - etiology ; Carotid Stenosis - diagnosis ; Carotid Stenosis - etiology ; Cavernous Sinus - pathology ; Cerebral Angiography ; Decompression, Surgical - methods ; Endoscopy - methods ; Humans ; Image Processing, Computer-Assisted ; Infarction, Middle Cerebral Artery - diagnosis ; internal carotid artery occlusion ; Magnetic Resonance Angiography ; Male ; Middle Aged ; Necrosis ; Paresis - etiology ; pituitary adenoma ; pituitary apoplexy ; Pituitary Apoplexy - complications ; Pituitary Apoplexy - diagnosis ; Pituitary Apoplexy - pathology ; Pituitary Apoplexy - surgery ; Pituitary Gland - pathology ; Pituitary Gland - surgery ; Pituitary Neoplasms - complications ; Pituitary Neoplasms - diagnosis ; Pituitary Neoplasms - pathology ; Pituitary Neoplasms - surgery ; Sphenoid Sinus ; Tomography, X-Ray Computed</subject><ispartof>Neurologia medico-chirurgica, 2011, Vol.51(1), pp.48-51</ispartof><rights>2011 by The Japan Neurosurgical Society</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c490t-42773aedcd5081c26b8666acad3910e3001f570866b724f4ee920d76236639653</citedby><cites>FETCH-LOGICAL-c490t-42773aedcd5081c26b8666acad3910e3001f570866b724f4ee920d76236639653</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,860,1877,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21273745$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>CHOKYU, Isao</creatorcontrib><creatorcontrib>TSUYUGUCHI, Naohiro</creatorcontrib><creatorcontrib>GOTO, Takeo</creatorcontrib><creatorcontrib>CHOKYU, Kimihiko</creatorcontrib><creatorcontrib>CHOKYU, Masahiro</creatorcontrib><creatorcontrib>OHATA, Kenji</creatorcontrib><creatorcontrib>Department of Neurosurgery</creatorcontrib><creatorcontrib>Chokyu Hospital</creatorcontrib><creatorcontrib>Osaka City University Graduate School of Medicine</creatorcontrib><title>Pituitary Apoplexy Causing Internal Carotid Artery Occlusion: Case Report</title><title>Neurologia medico-chirurgica</title><addtitle>Neurol. Med. Chir.(Tokyo)</addtitle><description>A 50-year-old man presented with pituitary apoplexy resulting in internal carotid artery occlusion manifesting as sudden onset of severe headache, right ptosis, and left hemiparesis, associated with visual impairment. Computed tomography showed a nodular mass, located in the sellar and suprasellar regions with early signs of acute cerebral ischemia. Magnetic resonance (MR) imaging indicated that the mass compressed the bilateral cavernous sinuses, resulting in obliteration of the cavernous portion of the right internal carotid artery. Right middle cerebral artery territory infarction was also found. Conservative therapy with steroids was given in the acute stage and repeated MR imaging showed recanalization of the internal carotid artery with reduction of the tumor size. The tumor was removed through the transsphenoidal approach to obtain a definitive diagnosis in the chronic stage. The histological diagnosis was consistent with non-functioning pituitary adenoma. Eye movement of this patient showed full recovery after the operation. Pituitary apoplexy resulting in internal carotid artery occlusion is rare. Surgical decompression through the transsphenoidal approach is appropriate, but the optimal timing should consider severe disturbance of visual acuity and visual field in the acute stage.</description><subject>Blepharoptosis - etiology</subject><subject>Carotid Stenosis - diagnosis</subject><subject>Carotid Stenosis - etiology</subject><subject>Cavernous Sinus - pathology</subject><subject>Cerebral Angiography</subject><subject>Decompression, Surgical - methods</subject><subject>Endoscopy - methods</subject><subject>Humans</subject><subject>Image Processing, Computer-Assisted</subject><subject>Infarction, Middle Cerebral Artery - diagnosis</subject><subject>internal carotid artery occlusion</subject><subject>Magnetic Resonance Angiography</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Necrosis</subject><subject>Paresis - etiology</subject><subject>pituitary adenoma</subject><subject>pituitary apoplexy</subject><subject>Pituitary Apoplexy - complications</subject><subject>Pituitary Apoplexy - diagnosis</subject><subject>Pituitary Apoplexy - pathology</subject><subject>Pituitary Apoplexy - surgery</subject><subject>Pituitary Gland - pathology</subject><subject>Pituitary Gland - surgery</subject><subject>Pituitary Neoplasms - complications</subject><subject>Pituitary Neoplasms - diagnosis</subject><subject>Pituitary Neoplasms - pathology</subject><subject>Pituitary Neoplasms - surgery</subject><subject>Sphenoid Sinus</subject><subject>Tomography, X-Ray Computed</subject><issn>0470-8105</issn><issn>1349-8029</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kE1LAzEQhoMotqgH_4Ds1cPWmXwviFCKXyDoQc8hzaaass2W7C7Yf2_qWg_JkHeeeTMzhFwizCgqeRM3biZwxvURmSLjVamBVsdkClxBqRHEhFx0XVgCUK450-qUTChSxRQXU3L7Fvoh9Dbtivm23Tb-e1cs7NCF-Fk8x96naJsspLYPdTFPWdgVr841mWjjOTlZ2abzF3_xjHw83L8vnsqX18fnxfyldLyCvuRUKWZ97WoBGh2VSy2ltM7WrELwDABXQkEWl4ryFfe-olArSZmUrJKCnZHr0deltuuSX5ltCpvcs0Ew-yWYvAQj0HCd2auR3Q7Lja__ycPIGXgcgZwNzjZtbEL0Zt0O-1k742qMfkjeUEA0AAJhH6p8uP59I5dUCMxOd6PTuuvtp___yqY-uMYfmsLxysWHhPuyyfjIfgBSLYMp</recordid><startdate>20110101</startdate><enddate>20110101</enddate><creator>CHOKYU, Isao</creator><creator>TSUYUGUCHI, Naohiro</creator><creator>GOTO, Takeo</creator><creator>CHOKYU, Kimihiko</creator><creator>CHOKYU, Masahiro</creator><creator>OHATA, Kenji</creator><general>The Japan Neurosurgical Society</general><general>THE JAPAN NEUROSURGICAL SOCIETY</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20110101</creationdate><title>Pituitary Apoplexy Causing Internal Carotid Artery Occlusion</title><author>CHOKYU, Isao ; TSUYUGUCHI, Naohiro ; GOTO, Takeo ; CHOKYU, Kimihiko ; CHOKYU, Masahiro ; OHATA, Kenji</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c490t-42773aedcd5081c26b8666acad3910e3001f570866b724f4ee920d76236639653</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Blepharoptosis - etiology</topic><topic>Carotid Stenosis - diagnosis</topic><topic>Carotid Stenosis - etiology</topic><topic>Cavernous Sinus - pathology</topic><topic>Cerebral Angiography</topic><topic>Decompression, Surgical - methods</topic><topic>Endoscopy - methods</topic><topic>Humans</topic><topic>Image Processing, Computer-Assisted</topic><topic>Infarction, Middle Cerebral Artery - diagnosis</topic><topic>internal carotid artery occlusion</topic><topic>Magnetic Resonance Angiography</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Necrosis</topic><topic>Paresis - etiology</topic><topic>pituitary adenoma</topic><topic>pituitary apoplexy</topic><topic>Pituitary Apoplexy - complications</topic><topic>Pituitary Apoplexy - diagnosis</topic><topic>Pituitary Apoplexy - pathology</topic><topic>Pituitary Apoplexy - surgery</topic><topic>Pituitary Gland - pathology</topic><topic>Pituitary Gland - surgery</topic><topic>Pituitary Neoplasms - complications</topic><topic>Pituitary Neoplasms - diagnosis</topic><topic>Pituitary Neoplasms - pathology</topic><topic>Pituitary Neoplasms - surgery</topic><topic>Sphenoid Sinus</topic><topic>Tomography, X-Ray Computed</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>CHOKYU, Isao</creatorcontrib><creatorcontrib>TSUYUGUCHI, Naohiro</creatorcontrib><creatorcontrib>GOTO, Takeo</creatorcontrib><creatorcontrib>CHOKYU, Kimihiko</creatorcontrib><creatorcontrib>CHOKYU, Masahiro</creatorcontrib><creatorcontrib>OHATA, Kenji</creatorcontrib><creatorcontrib>Department of Neurosurgery</creatorcontrib><creatorcontrib>Chokyu Hospital</creatorcontrib><creatorcontrib>Osaka City University Graduate School of Medicine</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Neurologia medico-chirurgica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>CHOKYU, Isao</au><au>TSUYUGUCHI, Naohiro</au><au>GOTO, Takeo</au><au>CHOKYU, Kimihiko</au><au>CHOKYU, Masahiro</au><au>OHATA, Kenji</au><aucorp>Department of Neurosurgery</aucorp><aucorp>Chokyu Hospital</aucorp><aucorp>Osaka City University Graduate School of Medicine</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pituitary Apoplexy Causing Internal Carotid Artery Occlusion: Case Report</atitle><jtitle>Neurologia medico-chirurgica</jtitle><addtitle>Neurol. Med. Chir.(Tokyo)</addtitle><date>2011-01-01</date><risdate>2011</risdate><volume>51</volume><issue>1</issue><spage>48</spage><epage>51</epage><pages>48-51</pages><issn>0470-8105</issn><eissn>1349-8029</eissn><abstract>A 50-year-old man presented with pituitary apoplexy resulting in internal carotid artery occlusion manifesting as sudden onset of severe headache, right ptosis, and left hemiparesis, associated with visual impairment. Computed tomography showed a nodular mass, located in the sellar and suprasellar regions with early signs of acute cerebral ischemia. Magnetic resonance (MR) imaging indicated that the mass compressed the bilateral cavernous sinuses, resulting in obliteration of the cavernous portion of the right internal carotid artery. Right middle cerebral artery territory infarction was also found. Conservative therapy with steroids was given in the acute stage and repeated MR imaging showed recanalization of the internal carotid artery with reduction of the tumor size. The tumor was removed through the transsphenoidal approach to obtain a definitive diagnosis in the chronic stage. The histological diagnosis was consistent with non-functioning pituitary adenoma. Eye movement of this patient showed full recovery after the operation. Pituitary apoplexy resulting in internal carotid artery occlusion is rare. Surgical decompression through the transsphenoidal approach is appropriate, but the optimal timing should consider severe disturbance of visual acuity and visual field in the acute stage.</abstract><cop>Japan</cop><pub>The Japan Neurosurgical Society</pub><pmid>21273745</pmid><doi>10.2176/nmc.51.48</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; EZB Electronic Journals Library; J-STAGE |
| subjects | Blepharoptosis - etiology Carotid Stenosis - diagnosis Carotid Stenosis - etiology Cavernous Sinus - pathology Cerebral Angiography Decompression, Surgical - methods Endoscopy - methods Humans Image Processing, Computer-Assisted Infarction, Middle Cerebral Artery - diagnosis internal carotid artery occlusion Magnetic Resonance Angiography Male Middle Aged Necrosis Paresis - etiology pituitary adenoma pituitary apoplexy Pituitary Apoplexy - complications Pituitary Apoplexy - diagnosis Pituitary Apoplexy - pathology Pituitary Apoplexy - surgery Pituitary Gland - pathology Pituitary Gland - surgery Pituitary Neoplasms - complications Pituitary Neoplasms - diagnosis Pituitary Neoplasms - pathology Pituitary Neoplasms - surgery Sphenoid Sinus Tomography, X-Ray Computed |
| title | Pituitary Apoplexy Causing Internal Carotid Artery Occlusion: Case Report |
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