A case of acromegaly diagnosed with putaminal hemorrhage

• Published in: Japanese Journal of Stroke Vol. 42; no. 5; pp. 423 - 428
• Main Authors: Nagashima, Ryo, Ohida, Tomoya, Ariyada, Kenichi, Tsutsumi, Kyousuke, Tanaka, Kentarou, Yanagibashi, Kazutaka, Nakamura, Yasunobu, Hanakawa, Kazuo, Murao, Masahiko, Ide, Takafumi
• Format: Journal Article
• Language: Japanese
• Published: The Japan Stroke Society 2020
• Subjects: acromegaly; cerebral hemorrhage; cerebral infarction; diabetes; hypertension
• ISSN: 0912-0726; 1883-1923
• DOI: 10.3995/jstroke.10680

The case is a 67-year-old man attending the internal medicine out-patient clinic nearby for the treatment of hypertension and diabetes for more than 10 years, but his blood pressure and blood sugar has been poorly controlled. The patient was diagnosed with left putaminal hemorrhage associated with right hemiplegia and aphasia, and was admitted to our hospital. The physical examination on the admission suggested acromegaly, leading to a definitive diagnosis of acromegaly at the screening after hospitalization. Since no compression on optic chiasm and severe paralysis were observed, rehabilitation was carried out, followed by the surgery to treat the pituitary tumor. After surgery, he visited hospital again, but cerebral infarction and TIA were recurred, resulting in the need for treatment and rehabilitation. As the underlying cause of cerebral hemorrhage and cerebral infarction in this case, the possible presence of secondary hypertension and diabetes mellitus associated with over-secretion of Growth Hormone (GH) was suggested. Early differential diagnosis should be needed considering the possible presence of secondary disease, which may lead to early treatment of the causative disease and contribute to improved prognosis in patients with hypertension and diabetes. A limited number of studies have reported on the patients with acromegaly accompanied by cerebrovascular dysfunction, whose mortality rate is considered to be higher compared with the general population. The early treatment of hypertension and diabetes may lead to improved prognosis in patients with acromegaly.