Subarachnoid Hemorrhage Due to Rupture of an Intracavernous Carotid Artery Aneurysm Coexisting with a Prolactinoma under Cabergoline Treatment.
Subarachnoid Hemorrhage Due to Rupture of an Intracavernous Carotid Artery Aneurysm Coexisting with a Prolactinoma under Cabergoline Treatment.
复制标题
蛛网膜下腔颈动脉动脉瘤破裂，与cabergoline治疗下催乳素瘤共存。
DOI：
10.1055/s-0033-1364166
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发表时间：
2014-08
影响因子：
0.5
通讯作者：
Kohmura E
中科院分区：
文献类型：
--
作者：
Akutsu N;Hosoda K;Ohta K;Tanaka H;Taniguchi M;Kohmura E
我们报告一个罕见的病例蛛网膜下腔出血引起术中破裂的海绵内颈动脉动脉瘤共存的催乳素瘤。一个58岁的男性，以复视的表现被发现有一个左侧海绵内颈动脉动脉瘤包裹的鞍上肿瘤的磁共振成像。血清催乳素5036 ng/mL。计划左颈内动脉近端结扎与颞浅动脉与大脑中动脉吻合。由于患者复视恶化，我们开始给他服用卡麦角林，剂量为0.25毫克，每周一次。卡麦角林给药1个月后复视有一定改善，血清催乳素降至290 ng/ml。在开始使用卡麦角林六周后，患者接受了左侧额颞叶开颅术来治疗动脉瘤。剖开硬脑膜后可见异常脑肿胀及明显蛛网膜下腔出血。术后计算机断层扫描显示蛛网膜下腔出血。本病例提示垂体腺瘤的药物治疗应在同时存在的海绵内动脉瘤治疗完成后开始。
We report an unusual case of subarachnoid hemorrhage caused by intraoperative rupture of an intracavernous carotid artery aneurysm coexisting with a prolactinoma. A 58-year-old man presenting with diplopia was found to have a left intracavernous carotid artery aneurysm encased by a suprasellar tumor on magnetic resonance imaging. His serum prolactin level was 5036 ng/mL. Proximal ligation of the left internal carotid artery with a superficial temporal artery to middle cerebral artery anastomosis was scheduled. Because the patient's diplopia had deteriorated, we started him on cabergoline at a dose of 0.25 mg once a week. One month after administration of cabergoline, the diplopia was improved to some extent and serum prolactin was decreased to 290 ng/ml. Six weeks after starting the cabergoline, the patient underwent a left frontotemporal craniotomy to treat the aneurysm. When the dura mater was opened, abnormal brain swelling and obvious subarachnoid hemorrhage were observed. Postoperative computed tomography demonstrated a thick subarachnoid hemorrhage. This case suggests that medical therapy for a pituitary adenoma should be started after treatment for a coexisting intracavernous aneurysm is completed.