title: Surgical treatment of pituitary apoplexy in association with hemispheric infarction.
abstract: We report a patient with pituitary apoplexy in whom cerebral infarction developed, possibly secondary to vasospasm. Pituitary apoplexy is a clinical syndrome caused by acute hemorrhage or infarction of the pituitary gland. Our patient's clinical symptoms and radiographic findings greatly improved after surgical resection of the apoplectic pituitary gland. An extensive literature review was performed, including all previously reported cases of pituitary apoplexy leading to cerebral infarction. The clinical features, pathophysiological mechanisms, management and outcome of cerebral infarction following pituitary apoplexy are discussed. We show that cerebral infarction following pituitary apoplexy is associated with much poor prognosis. Early surgical decompression of the tumor and hemisphere should be performed in patients with severe or progressive neurological deficits, however, those with less severe presentations may be treated conservatively or with delayed elective surgery.
authors.affiliation: Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou 350001, China.
authors.forename: Zhangyu
authors.initials: Z
authors.lastname: Zou
authors.affiliation: Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou 350001, China.
authors.forename: Changyun
authors.initials: C
authors.lastname: Liu
authors.affiliation: Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Sun
authors.affiliation: Department of Neurosurgery, Fujian Medical University Union Hospital, Fuzhou, China.
authors.forename: Chunmei
authors.initials: C
authors.lastname: Chen
authors.affiliation: Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou 350001, China.
authors.forename: Wentin
authors.initials: W
authors.lastname: Xiong
authors.affiliation: Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou 350001, China.
authors.forename: Chunhui
authors.initials: C
authors.lastname: Che
authors.affiliation: Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou 350001, China. Electronic address: hh-p@163.com.
authors.forename: Huapin
authors.initials: H
authors.lastname: Huang
mesh_terms: D000236:Adenoma / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism; D000328:Adult; D002543:Cerebral Hemorrhage / Q000150:complications*; D002544:Cerebral Infarction / Q000150:complications*; D003399:Craniotomy; D019299:Decompression, Surgical; D017558:Elective Surgical Procedures; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D018908:Muscle Weakness / Q000209:etiology; D010291:Paresis / Q000209:etiology; D010899:Pituitary Apoplexy / Q000150:complications / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D010911:Pituitary Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism; D011379:Prognosis; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014474:Unconsciousness / Q000209:etiology; D014786:Vision Disorders / Q000209:etiology; D014792:Visual Acuity
chemical_list: D019382:Human Growth Hormone
keywords: Cerebral infarction; Compression; Pituitary apoplexy; Surgery; Vasospasm