DOI QR코드

DOI QR Code

Pituitary Apoplexy Following Mitral Valvuloplasty

  • Kim, Young Ha (Department of Neurosurgery, School of Medicine, Pusan National University) ;
  • Lee, Sang Weon (Department of Neurosurgery, School of Medicine, Pusan National University) ;
  • Son, Dong Wuk (Department of Neurosurgery, School of Medicine, Pusan National University) ;
  • Cha, Seung Heon (Department of Neurosurgery, School of Medicine, Pusan National University)
  • Received : 2014.02.10
  • Accepted : 2014.12.23
  • Published : 2015.04.28

Abstract

Pituitary apoplexy is a rare but potentially life-threatening clinical syndrome caused by the sudden enlargement of a pituitary adenoma secondary to hemorrhage or infarction. Pituitary apoplexy after cardiac surgery is a very rare perioperative complication. Factors associated with open heart surgery that may lead to pituitary apoplexy include hemodynamic instability during cardiopulmonary bypass and systemic heparinization. We report a case of pituitary apoplexy after mitral valvuloplasty with cardiopulmonary bypass. After early pituitary tumor resection and hormonal replacement therapy, the patient made a full recovery.

Keywords

References

  1. Bailey P : Pathological report of a case of acromegaly, with special reference to the lesions in the hypophysis cerebri and in the thyroid gland; and a case of haemorrhage in to the pituitary. Philadelphia Med J 1 : 789-792, 1898
  2. Bills DC, Meyer FB, Laws ER Jr, Davis DH, Ebersold MJ, Scheithauer BW, et al. : A retrospective analysis of pituitary apoplexy. Neurosurgery 33 : 602-608; discussion 608-609, 1993 https://doi.org/10.1227/00006123-199310000-00007
  3. Biousse V, Newman NJ, Oyesiku NM : Precipitating factors in pituitary apoplexy. J Neurol Neurosurg Psychiatry 71 : 542-545, 2001 https://doi.org/10.1136/jnnp.71.4.542
  4. Bleibtreu L : Ein Fall von Akromegalie (Zerstorung der Hypophysis durch Blutung). Munch Med Wochenschr 41 : 2079-2080, 1905
  5. Brougham M, Heusner AP, Adams RD : Acute degenerative changes in adenomas of the pituitary body--with special reference to pituitary apoplexy. J Neurosurg 7 : 421-439, 1950 https://doi.org/10.3171/jns.1950.7.5.0421
  6. Cardoso ER, Peterson EW : Pituitary apoplexy : a review. Neurosurgery 14 : 363-373, 1984 https://doi.org/10.1227/00006123-198403000-00021
  7. Cooper DM, Bazaral MG, Furlan AJ, Sevilla E, Ghattas MA, Sheeler LR, et al. : Pituitary apoplexy : a complication of cardiac surgery. Ann Thorac Surg 41 : 547-550, 1986 https://doi.org/10.1016/S0003-4975(10)63039-1
  8. De la Torre M, Alcázar R, Aguirre M, Ferreras I : The dialysis patient with headache and sudden hypotension : consider pituitary apoplexy. Nephrol Dial Transplant 13 : 787-788, 1998 https://doi.org/10.1093/ndt/13.3.787
  9. Goel A, Deogaonkar M, Desai K : Fatal postoperative 'pituitary apoplexy' : its cause and management. Br J Neurosurg 9 : 37-40, 1995 https://doi.org/10.1080/02688699550041728
  10. Levy E, Korach A, Merin G, Feinsod M, Glenville B : Pituitary apoplexy and CABG : should we change our strategy? Ann Thorac Surg 84 : 1388-1390, 2007 https://doi.org/10.1016/j.athoracsur.2007.05.017
  11. Mizuno T : Pituitary apoplexy with third cranial nerve palsy after off-pump coronary artery bypass grafting. Interact Cardiovasc Thorac Surg 13 : 240-242, 2011 https://doi.org/10.1510/icvts.2011.268854
  12. Mukhida K, Kolyvas G : Pituitary apoplexy following cardiac surgery. Can J Neurol Sci 34 : 390-393, 2007 https://doi.org/10.1017/S0317167100006910
  13. Nagarajan DV, Bird D, Papouchado M : Pituitary apoplexy following anticoagulation for acute coronary syndrome. Heart 89 : 10, 2003 https://doi.org/10.1136/heart.89.1.10
  14. Nawar RN, AbdelMannan D, Selman WR, Arafah BM : Pituitary tumor apoplexy : a review. J Intensive Care Med 23 : 75-90, 2008 https://doi.org/10.1177/0885066607312992
  15. Semple PL, Webb MK, de Villiers JC, Laws ER Jr : Pituitary apoplexy. Neurosurgery 56 : 65-72; discussion 72-73, 2005 https://doi.org/10.1227/01.NEU.0000144840.55247.38
  16. Woo HJ, Hwang JH, Hwang SK, Park YM : Clinical outcome of cranial neuropathy in patients with pituitary apoplexy. J Korean Neurosurg Soc 48 : 213-218, 2010 https://doi.org/10.3340/jkns.2010.48.3.213