Open AccessAcute Ischaemic Stroke as a Manifestation of Pituitary Apoplexy in a Young Lady
Author(s) -
Shaik Afsar Pasha,
Laxmi Narasimhan Ranganthan,
Vamsi Krishna Setty,
Ramakrishna L. Reddy,
Deepika Ponnuru
Publication year - 2017
Publication title -
journal of clinical and diagnostic research
Language(s) - English
Resource type - Journals
eISSN - 2249-782X
pISSN - 0973-709X
DOI - 10.7860/jcdr/2017/25046.9782
Subject(s) - medicine , pituitary apoplexy , internal carotid artery , pituitary adenoma , bleed , surgery , stroke (engine) , debulking , radiology , occlusion , infarction , adenoma , myocardial infarction , cancer , mechanical engineering , ovarian cancer , engineering
Pituitary Apoplexy (PA) is defined as a clinical syndrome comprising headache, visual deficits and altered sensorium, which can result from haemorrhage or infarction of the pituitary gland. Acute ischaemic stroke following PA is very rare. We are presenting a 35-year-old young otherwise healthy lady who presented with neuro ophthalmological and vascular symptoms on a background of PA. Imaging revealed a pituitary macro adenoma with parasellar extension with internal bleed. Cerebral angiography revealed that the mass compressed the bilateral cavernous sinuses (left more than right), resulting in obliteration of the cavernous portion of the left Internal Carotid Artery (ICA). She was treated with steroids and surgical debulking of the tumour through trans-sphenoidal approach and postoperative imaging showed recanalization of the ICA with reduction of the tumour size. The histopathological diagnosis was consistent with pituitary macro adenoma. Patient improved in level of sensorium, eye movement and the patient showed almost full recovery after the operation. PA resulting in ICA occlusion is very rare. Early intervention is required for reducing mortality and morbidity and to improve quality of life.