垂体性脑瘫的内窥镜经蝶窦入路 - 病例报告

Q4 Medicine
Vinod Shinde, Mayur Ingale, Anvitha Suresh, Deepak Ranade
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引用次数: 0

摘要

摘要 垂体中风是一种罕见的内分泌急症,偶尔会危及生命,最常见的是垂体大腺瘤。大多数垂体大腺瘤无分泌功能,在晚期才被诊断出来。直到它们对周围重要结构造成压迫并导致随后出现症状时,才会被诊断出来。临床特征取决于肿瘤的大小和扩散方向。手术有两种方法。与经颅入路相比,创伤较小的内镜下经鼻腔经蝶窦入路更受青睐。 46 岁的女性患者因头痛和右眼睑下垂 1.5 个月来到门诊部(OPD)就诊。经神经系统检查,患者右眼严重下垂,右眼的眼外肌运动受限于第三神经供应的肌肉。瞳孔对光线有反应。视力检查显示左眼颞侧偏盲。由于上睑下垂,没有进行右眼视力测定。脑部核磁共振成像给出的鉴别诊断是垂体大腺瘤伴出血或坏死,以及无大腺瘤的垂体中风。在全身麻醉的情况下,进行了内窥镜下经鼻腔经蝶窦肿瘤切除术。 脑部核磁共振成像是高度怀疑垂体性脑瘫病例的首选成像方法。内镜下经鼻腔经蝶窦切除肿瘤是手术切除垂体腺瘤的最佳选择,可提高肿瘤的完全切除率,降低并发症的发生率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Endoscopic Transsphenoidal Approach in Pituitary Apoplexy – A Case Report
ABSTRACT Pituitary apoplexy is a rare endocrine emergency that is occasionally life-threatening, most often involving pituitary macroadenomas. Most pituitary macroadenomas are nonsecretory and are diagnosed in the late stages. They remain undiagnosed until they cause compression of the surrounding vital structures and lead to subsequent symptoms. The clinical feature depends on the size of the tumor and the direction of the spread. There are two approaches for surgery. The less invasive endoscopic transnasal transsphenoidal approach is favored more than the transcranial approach. 46-year-old female patient presented to the outpatient department (OPD) with complaints of headache and drooping of the right eyelid for 1.5 months. On neurological examination, right severe ptosis was present and extraocular movements of the right eye are restricted for the muscles supplied by the third nerve. Pupils were reactive to light. On perimetry, the left eye showed temporal hemianopia. Right eye perimetry was not done due to ptosis. MRI Brain gave differential diagnosis as pituitary macroadenoma with hemorrhage or necrosis and pituitary apoplexy without macroadenoma. Endoscopic transnasal transsphenoidal excision of the tumor under general anesthesia was performed. MRI brain is the preferred imaging for cases with high suspicion of pituitary apoplexy. Endoscopic transnasal transsphenoidal excision of the tumor is an excellent choice for surgical resection of pituitary adenomas, with improved rates of complete tumor removal and reduced incidence of complication.
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来源期刊
CiteScore
0.30
自引率
0.00%
发文量
221
审稿时长
43 weeks
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