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Cerebral ischaemia in pituitary disorders—more common than previously thought: two case reports and literature review

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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.

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Authors and Affiliations

  1. Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore, 119228, Singapore

    Margaret Yanfong Chong & Su Min Quak

  2. Department of Anaesthesiology, Intensive Care and Pain Medicine, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore

    Chin Ted Chong

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  1. Margaret Yanfong Chong
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  2. Su Min Quak
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  3. Chin Ted Chong
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Correspondence to Chin Ted Chong.

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Chong, M.Y., Quak, S.M. & Chong, C.T. Cerebral ischaemia in pituitary disorders—more common than previously thought: two case reports and literature review. Pituitary 17, 171–179 (2014). https://doi.org/10.1007/s11102-013-0485-1

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