Angioplasty is an Effective Treatment for Vasospasm Following Pituitary Apoplexy and Tumor Resection

Pituitary apoplexy is a clinical syndrome characterized by acute headache, visual changes, and decreased consciousness occurring in association with hemorrhage or infarct of an existing pituitary adenoma. Surgical management involves tumor resection and decompression of surrounding structures includ...

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Published inCurēus (Palo Alto, CA) Vol. 10; no. 1; p. e2117
Main Authors Douleh, Diana G, Morone, Peter J, Mobley, Bret, Fusco, Matthew R, Chambless, Lola B
Format Journal Article
LanguageEnglish
Published United States Cureus Inc 26.01.2018
Cureus
Subjects
Angioplasty
Bone surgery
Carotid arteries
Case reports
Diabetes
Gangrene
Hemorrhage
Hypertension
Ischemia
Medical imaging
Neurosurgery
NMR
Nuclear magnetic resonance
Stents
Surgeons
Tumors
Urine
Veins & arteries
United States > US
Massachusetts
endovascular
pituitary apoplexy
vasospasm
verapamil
angioplasty
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Summary:Pituitary apoplexy is a clinical syndrome characterized by acute headache, visual changes, and decreased consciousness occurring in association with hemorrhage or infarct of an existing pituitary adenoma. Surgical management involves tumor resection and decompression of surrounding structures including the optic apparatus. Vasospasm is a rare but potentially devastating complication of pituitary apoplexy. We present a case of pituitary apoplexy in a 28-year-old male treated with emergent endoscopic transsphenoidal resection. On postoperative day seven, following  surgical resection, the patient developed neurologic deficits and motor weakness, and severe vasospasm was diagnosed. This is a novel case of intra-arterial verapamil and angioplasty used to treat vasospasm following surgical decompression for pituitary apoplexy. The patient experienced complete recovery of motor deficits following treatment. The authors propose angioplasty as an effective treatment for postoperative vasospasm following transphenoidal surgery for pituitary apoplexy in the presence of focal vessel stenosis.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.2117