Extrapontine myelinolysis and behavioral change after transsphenoidal pituitary surgery: case report.
OBJECTIVE
Rapid correction of hyponatremia is considered the usual cause of central pontine myelinolysis and extrapontine myelinolysis. Little has been reported about mental changes associated with this disorder or its occurrence after transsphenoidal surgery.


METHODS
A 24-year-old woman suddenly developed markedly abnormal behavior associated with rapid correction of hyponatremia 11 days after undergoing transsphenoidal surgery for a prolactin-secreting pituitary adenoma.


METHODS
Magnetic resonance imaging and positron emission tomography with 18F-fluorodeoxyglucose showed bilateral caudate nuclei and putaminal lesions. Gradual, complete clinical resolution preceded the resolution that was revealed by magnetic resonance imaging.


CONCLUSIONS
We emphasize the importance of cautious correction with frequent electrolyte determinations and attention to behavioral changes in the management of delayed hyponatremia after pituitary tumor surgery.
Department of Neurosurgery, Gunma University School of Medicine, Maebashi, Japan.
M
M
Tosaka
H
H
Kohga
D000236:Adenoma / Q000601:surgery*; D000328:Adult; D002421:Caudate Nucleus / Q000473:pathology; D005260:Female; D006801:Humans; D007016:Hypophysectomy; D008279:Magnetic Resonance Imaging; D001523:Mental Disorders / Q000175:diagnosis*; D017590:Myelinolysis, Central Pontine / Q000175:diagnosis*; D010911:Pituitary Neoplasms / Q000601:surgery*; D011149:Pons / Q000473:pathology; D011182:Postoperative Care; D011183:Postoperative Complications / Q000175:diagnosis*; D011699:Putamen / Q000473:pathology; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage / Q000009:adverse effects*; D013101:Sphenoid Sinus / Q000601:surgery
D012462:Saline Solution, Hypertonic