title: Cerebral ischaemia in pituitary disorders--more common than previously thought: two case reports and literature review.
abstract: Vasospasm and consequent cerebral ischaemia in aneurysmal subarachnoid haemorrhage are well-described. The development of cerebral ischaemia following pituitary tumour surgery is under-appreciated, and can be attributed to mainly cerebral vasospasm or internal carotid artery compression. We report on two patients with pituitary tumours who developed delayed cerebral ischaemia after transsphenoidal and transcranial pituitary macroadenoma decompression. The patients had vasospasm of intracranial vessels demonstrable on magnetic resonance angiogram. One recovered neurologically following nimodipine and hypertensive-hypervolaemia therapy while the other developed fulminant cerebral infarction. We discuss the complex multi-factorial mechanisms of cerebral ischaemia in pituitary disorders, as well as the management strategies and their limitations.
authors.affiliation: Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore, 119228, Singapore.
authors.forename: Margaret Yanfong
authors.initials: MY
authors.lastname: Chong
authors.forename: Su Min
authors.initials: SM
authors.lastname: Quak
authors.forename: Chin Ted
authors.initials: CT
authors.lastname: Chong
mesh_terms: D000236:Adenoma / Q000150:complications* / Q000601:surgery; D000328:Adult; D002545:Brain Ischemia / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D017809:Fatal Outcome; D005260:Female; D006438:Hemodilution; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects; D010900:Pituitary Diseases / Q000150:complications* / Q000601:surgery; D010911:Pituitary Neoplasms / Q000150:complications* / Q000601:surgery; D016896:Treatment Outcome