Pituitary apoplexy producing internal carotid artery compression: a case report

We report a case of pituitary apoplexy resulting in right internal carotid artery occlusion accompanied by hemiplegia and lethargy. A 43-yr-old man presented with a sudden onset of severe headache, visual disturbance and left hemiplegia. Investigations revealed a nodular mass, located in the sella a...

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Bibliographic Details
Published in:Journal of Korean medical science 2008, 23(6), , pp.1113-1117
Main Authors: Yang, Seung-Ho, Lee, Kwan-Sung, Lee, Kyo-Young, Lee, Sang Won, Hong, Yong-Kil
Format: Article
Language:English
Subjects:
Adult
Carotid Artery Diseases - diagnosis
Carotid Artery Diseases - etiology
Carotid Artery Diseases - therapy
Carotid Artery, Internal - pathology
Carotid Artery, Internal - surgery
Case Report
Diagnosis, Differential
Embolization, Therapeutic
Humans
Magnetic Resonance Angiography
Male
Pituitary Apoplexy - complications
Pituitary Apoplexy - diagnosis
Tomography, X-Ray Computed
의학일반
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Summary:We report a case of pituitary apoplexy resulting in right internal carotid artery occlusion accompanied by hemiplegia and lethargy. A 43-yr-old man presented with a sudden onset of severe headache, visual disturbance and left hemiplegia. Investigations revealed a nodular mass, located in the sella and suprasellar portion and accompanied by compression of the optic chiasm. The mass compressed the bilateral cavernous sinuses, resulting in the obliteration of the cavernous portion of the right internal carotid artery. A border zone infarct in the right fronto-parietal region was found. Transsphenoidal tumor decompression following conservative therapy with fluid replacement and steroids was performed. Pathological examination revealed an almost completely infarcted pituitary adenoma. The patient's vision improved immediately after the decompression, and the motor weakness improved to grade IV(+) within six months after the operation. Pituitary apoplexy resulting in internal carotid artery occlusion is rare. However, clinicians should be aware of the possibility and the appropriate management of such an occurrence.
ISSN:1011-8934
1598-6357
DOI:10.3346/jkms.2008.23.6.1113