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Journal of Korean Neurosurgical Society 1997;26(3): 452-457.
A Case of Cavernous ICA Occlusion after Radiation Therapy in Pituitary Adenoma.
Eung Doo Kim, Beong Chul Rim, Keong Soo Min, Moo Seop Lee, Young Gyu Kim, Dong Ho Kim
Department of Neurosurgery, College of Medicine, Chungbuk National University Hospital, CheongJu, Korea.
Stenosis or occlusion of large arteries after radiation are rare. The authors report a case of internal carotid arterial occlusion after radiation therapy. The patient was 45 year-old female. She received postoperative radiation therapy, a total dose of 4940cGy, to treat the remnant tumor after transsphenoidal surgery for the asymptomatic nonfunctioning pituitary adenoma. She suffered intermittant ischemic symptoms from 18 month after radiation therapy, and died with global infarction due to stenotic occlusion of the internal carotid artery at 30 month after surgery. Endocrine or vascular complications occasionally follow radiation therapy of pituitary tumor. But with improved therapies for pituitary tumors and hypopituitarism, patients are expect to live longer. Yet we must consider another delayed complication of radiation induced carotid arterial disease. As a whole, hemispheric transient ischemic attacks, amaurosis fugax, and seizure are the major presenting symptoms and signs. In such a case, it is important to consider the possibility of radiation induced arterial stenosis, and prompt cerebral angiography and proper management are mandatory.
Key Words: Pituitary adenoma; Radiation therepy; Delayed complication; Carotid stenosis; Cerebral angiography
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