Rinsho Shinkeigaku (Clinical Neurology)

Case Report

Case report: transient ischemic stroke caused by internal carotid artery occlusion due to compression by pituitary apoplexy and hemodynamic mechanism

Go Hashimoto, M.D.1), Shinichi Wada, M.D., Ph.D.1), Fumitaka Yoshino, M.D.1), Takahiro Kuwashiro, M.D., Ph.D.1), Masahiro Yasaka, M.D., Ph.D.1) and Yasushi Okada, M.D., Ph.D.1)

1)Division of Cerebrovascular Medicine and Neurology, National Hospitalization Organization, Kyushu Medical Center

An 87-year-old blind man was admitted due to repeatedly disturbed consciousness and fever. Brain CT showed a pituitary tumor with a hematoma and an occlusive lesion of the right internal carotid artery. He experienced consciousness disturbance and left limb weakness with hypotension for a few minutes on the day of admission. We considered pituitary apoplexy caused adrenal failure with hypotension and transient ischemic attack (TIA) induced by a hemodynamic mechanism. An increased dose of hydrocortisone improved the fever and hypotension, and resolved consciousness disturbance. This is a unique example of TIA caused by the occlusive lesion of the internal carotid artery compressed as a result of pituitary apoplexy and a hemodynamic mechanism.
Full Text of this Article in Japanese PDF (1953K)

(CLINICA NEUROL, 60: 146|151, 2020)
key words: pituitary apoplexy, hemodynamic, adrenal insufficiency, ischemic stroke

(Received: 23-Sep-19)