Minimally invasive pituitary surgery in a hemorrhagic necrosis of adenoma during pregnancy.
A 29-year-old woman with a prolactin microadenoma was under good control with bromocriptine (BCP) therapy until she became pregnant, when the treatment was stopped. During the third trimester of pregnancy the patient presented a unilateral visual loss and intermittent headaches. BCP was restarted and one week later she developed a complete ophthalmoplegia on the other side. The patient was submitted to an endoscopic transnasal transeptal resection of a hematoma and tumoral tissue in the pituitary region. One month after surgery, at 39 weeks of gestation, the patient spontaneously delivered a healthy girl weighing 3 kg, with an Apgar score of 9 and 10 at five minutes. This is the first case in the literature of a pregnant woman with second and third cranial nerve lesions, submitted to minimally invasive neuroendoscopic transnasal transsphenoidal approach in the third trimester of pregnancy.
Gondim
J
J
Department of Neurosurgery, General Hospital of Fortaleza, Brazil. jagondim@secrel.com.b
Ramos Júnior
F
F
Pinheiro
I
I
Schops
M
M
Tella Júnior
O I
OI
D000328:Adult; D001971:Bromocriptine / Q000627:therapeutic use; D005260:Female; D006406:Hematoma; D006470:Hemorrhage / Q000209:etiology / Q000473:pathology; D006727:Hormone Antagonists / Q000627:therapeutic use; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D009336:Necrosis; D019635:Neurosurgical Procedures / Q000379:methods*; D019574:Optic Nerve Neoplasms / Q000473:pathology / Q000601:surgery*; D010911:Pituitary Neoplasms / Q000150:complications* / Q000601:surgery*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000601:surgery*; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D015175:Prolactinoma / Q000150:complications* / Q000601:surgery*
D006727:Hormone Antagonists; D001971:Bromocriptine