gms | German Medical Science

64th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

26 - 29 May 2013, Düsseldorf

Pituitary apoplexy caused by pituitary adenoma associated with symptomatic compression of both internal carotid arteries – a case report and a review of similar cases

Meeting Abstract

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  • Falko Wahnschaff - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Jena
  • Albrecht Waschke - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Jena
  • Rolf Kalff - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Jena

Deutsche Gesellschaft für Neurochirurgie. 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Düsseldorf, 26.-29.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocP 090

doi: 10.3205/13dgnc507, urn:nbn:de:0183-13dgnc5075

Published: May 21, 2013

© 2013 Wahnschaff et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Objective: The authors report a case of pituitary apoplexy caused by pituitary adenoma associated with symptomatic mechanical compression of both internal carotid arteries. A 64-year-old woman was admitted to our emergency department complaining of sudden onset of focal headache and right-sided hemiparesis. Following steroid therapy, the patient underwent a transsphenoidal tumor resection. Thereafter she revealed excellent clinical recovery.

Method: Here, we describe the presenting symptoms, pathophysiology, imaging findings, treatment strategy as well as other cases of this rare condition.

Results: In the literature only 10 cases of pituitary apoplexy with symptomatic compression of major vessels are described. In most of these cases, tumor excision was performed via open or transsphenoidal resection techniques. Concerning therapeutic measures, no specific guidelines exist at present.

Conclusions: The treatment of choice for the remaining patients requires the initiation of steroid therapy for at least one day followed by transsphenoidal resection. Conservative measures should only be used if surgery is for any reason contraindicated.