TITLE

Vasospasm and Cerebral Infarction from Pituitary Apoplexy

AUTHOR(S)
Cerase, A.; Tarantino, A.; Muzii, V. F.; Vittori, C.; Venturi, C.
PUB. DATE
June 2010
SOURCE
Neuroradiology Journal;Jun2010, Vol. 23 Issue 3, p321
SOURCE TYPE
Academic Journal
DOC. TYPE
Case Study
ABSTRACT
Pituitary apoplexy is a potentially life-threatening acute or subacute clinical syndrome occurring from enlargement of the pituitary gland, and pituitary insufficiency, from hemorrhage or ischemia from an unknown pituitary lesion, most frequently being a non-functioning macroadenoma. A close, and multidisciplinary management is required. The purpose of this case report is to increase awareness to pituitary apoplexy presentation and management by reporting clinical features and neuroradiological findings observed in a 70-year-old patient with an unknown pituitary lesion. He presented with pituitary apoplexy and brain ischemia at magnetic resonance imaging (MRI) including diffusion-weighted imaging (DWI), and apparent diffusion coefficient (ADC) maps. MR angiography (MRA) showed diffuse vasospasm of anterior and posterior circulation. Both MRI and cytochemical examination of the cerebrospinal fluid ruled out subarachnoid hemorrhage. Due to concomitant diseases, and absence of visual deficit, the management was conservative by medical and substitutive therapy, without surgery. Clinical follow-up showed clearcut improvement, and this was consistent with MRI and MRA evidence of vasospasm regression, and clearcut pituitary lesion shrinkage. Pituitary lesions with hemorrhagic infarction presenting with pituitary apoplexy may be associated with vasospasm and brain ischemia at diagnosis, also in the absence of subarachnoid hemorrhage. A correct MR evaluation of patients with PA should include DWI, ADC maps, and MRA. Notably, early diagnosis of PA-associated vasospasm and cerebral ischemia avoids the possibility of their detection only after neurosurgery.
ACCESSION #
53277276

 

Related Articles

  • SIGNS OF A STROKE. Donaldson, Doug // Better Homes & Gardens;Apr2006, Vol. 84 Issue 4, p274 

    The article provides information about stroke and gives tips on how to identify its symptoms. There exists two kinds of stroke, one is caused by clots in the proper blood flow while the other is caused by broken blood vessels in the brain. Symptoms include the inability of a person to raise both...

  • Reversal of Radiographically Impending Stroke with Multiple Intraarterial Papaverine Infusions in Severe Diffuse Cerebral Vasospasm Induced by Subarachnoid Hemorrhage. Liu, J. K.; Tenner, M. S.; Oestreich, H. M.; Couldwell, W. T. // Acta Neurochirurgica;Dec2001, Vol. 143 Issue 12, p1249 

    Summary.Background: Selective intraarterial infusion of papaverine is used in the treatment of symptomatic cerebral vasospasm induced by aneurysmal subarachnoid hemorrhage (SAH). Delays in instituting therapy for vasospasm can lead to irreversible cerebral infarction and a devastating outcome....

  • Application of Greek Stroke Score in Ethiopia. A validation study. Berhe, T.; Zenebe, G.; Melkamu, Y. // Internet Journal of Neurology;2009, Vol. 11 Issue 1, p1 

    Objective: To assess the applicability of Greek stroke score in Addis Abeba, Ethiopia. Method: Using a cross sectional study design, acute stroke patients who had CT scan done were evaluated with Greek stroke score. Sensitivity, specificity, positive & negative predictive values were tested....

  • Cerebrovascular Accident.  // Diseases & Disorders: A Nursing Therapeutics Manual, 2nd edition;2002, p225 

    Provides information on cerebrovascular accident or stroke. Causes; Assessment and diagnosis; Recommendations for medical management of stroke patients.

  • Assessment of Stroke Outcome Based on Initial Stroke Severity Measured on Different Stroke Severity Scales. Quddus, Abdul; Rahman, Matiur; Ahmed, Faisal; Mondol, Badrul Alam; Rahman Siddiqui, Md. Mahmudur // Journal of Medicine;Jul2010, Vol. 11 Issue 2, p137 

    Background: Stroke is the second most common cause of death globally and the major cause of disability. Though a number of studies have been conducted on stroke outcome and recovery of walking function, the list and effects of predictive factors are still a major challenge to stroke...

  • Ten year recurrence after first ever stroke in a Japanese community: the Hisayama study. Hata, J.; Tanizaki, Y.; Kiyohara, Y.; Kato, I.; Kubo, M.; Tanaka, K.; Okubo, K.; Nakamura, H.; Oishi, Y.; Ibayashi, S.; Iida, M. // Journal of Neurology, Neurosurgery & Psychiatry;Mar2005, Vol. 76 Issue 3, p368 

    Background: Very few population based cohort studies have focused on the long term recurrence of stroke.Objective: To examine 10 year cumulative recurrence rates for stroke in a Japanese cohort according to pathological type and clinical subtype of brain...

  • Diffusion-weighted MR imaging in the early diagnosis of periventricular leukomalacia. Bozzao, Alessandro; Di Paolo, Ambrogio; Mazzoleni, Clarissa; Fasoli, Fabrizio; Simonetti, Alessandra; Fantozzi, Luigi Maria; Floris, Roberto // European Radiology;Jul2003, Vol. 13 Issue 7, p1571 

    Diffusion-weighted imaging (DWI) has been shown to be highly sensitive in detecting acute cerebral infarction, but its use in detecting hypoxic-ischemic encephalopathy (HIE) in neonates is still controversial. Moreover, few reports concern pre-term infants with possible periventricular...

  • Imaging of acute stroke. Choksi, Vaishali; Quint, Douglas J.; Maly-Sundgren, Pia; Hoeffner, Ellen // Applied Radiology;Jan2005, Vol. 34 Issue 1, p10 

    Presents information on symptomatic cerebral infarction or stroke. Number of people affected with stroke each year in the U.S.; Advantage of intravenous recombinant tissue plasminogen activator administered to patients with ischemic stroke, according to a report by the National Institute of...

  • Diffusion-weighted imaging provides support for secondary neuronal damage from intraparenchymal hematoma. Forbes, K. P.; Pipe, J. G.; Heiserman, J. E. // Neuroradiology;Jun2003, Vol. 45 Issue 6, p363 

    Abstract It is controversial whether an intracerebral hematoma (ICH) causes ischemia of surrounding brain. By virtue of its high sensitivity to acute cerebral infarction, diffusion-weighted imaging (DWI) helps answer this question. We used this technique to assess the parenchyma surrounding ICH...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics