Post traumatic pituitary apoplexy with contiguous intra cerebral hematoma operated through endonasal route--a case report.
Pituitary apoplexy is a clinical syndrome occurring as a consequence of fulminant expansion of pituitary tumor due to massive infarction, necrosis, and hemorrhage. Its association with head injury is rare and only few reports are available. Shear forces on stalk and arterial vasospasm have been proposed to be the possible reasons. The clinical picture is characterized by sudden onset headache, visual symptoms, multiple cranial nerves involvement, meningismus, altered mental status, and hormonal dysfunction. Transsphenoidal decompression is the standard treatment but suprasellar and widespread extension of hematoma may need intracranial approach. We are reporting a rare association of head injury with pituitary apoplexy, where endonasal surgery proved to be a simple useful approach to evacuate contiguous intra-cerebral hematoma with excision of apoplectic pituitary adenoma.
Dev
Ravi
R
Department of Neurosurgery, King George's Medical University, Lucknow 226003, India. ravidev@hotmail.com
Singh
Sunil Kumar
SK
Sharma
Mahesh Chandra
MC
Khetan
Prakash
P
Chugh
Ashish
A
D000063:Accidents, Traffic; D000328:Adult; D020202:Cerebral Hemorrhage, Traumatic / Q000150:complications* / Q000473:pathology / Q000601:surgery*; D019299:Decompression, Surgical; D006801:Humans; D008297:Male; D009049:Motorcycles; D009296:Nasal Cavity / Q000601:surgery*; D010899:Pituitary Apoplexy / Q000209:etiology* / Q000473:pathology / Q000601:surgery*; D010902:Pituitary Gland / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed