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Journal of Korean Neurosurgical Society 1973;2(2): 111-115.
A Case of Pituitary Apoplexy.
Hak Jong Ko, Maeng Ki Cho, Jin Chae, Kil Soo Choi, Bo Sung Sim
Department of Neurosurgery, Seoul National University, College of Medicine, Seoul, Korea.
A 46 years old woman was admitted to the department of Neurosurgery, Seoul National University, complaining of a sudden severe headaches and vomiting 7 days before admission. Three days later her vision became poor in the left eye and totally blind on the day of admission. She had amenorrhea for 15 years. On neurological examination, she was somewhat lethargic but fully conscious. Both optic discs were normal. Left pupil was dilated, fixed and totally ophthalmoplegic. Because of poor cooperation the visual field examination was not performed. Tongue protrusion was deviated to the right side. Cerebrospinal fluid was bloody. Skull X-rays showed a large pituitary fossa with erosion of the left anterior clinoid process and dorsum sellae. Left carotid anyiogram showed a finding of suprasellar extension of the intrasella mass. Retrograde brachial angiogram showed remarkable posterior displacement of the distal portion of the basilar artery. Left subfrontal approach was done and found a huge suprasellar mass compressing the left optic nerve. The tumor was aspirated and blood clot was obtained. The capsule was incised and content with hematoma was evacuated. Histologic examination showed complete blood clot with no recognizable neoplasm. Post-operatively, her left eyeball began to move and she was able to see some objects in close distance few hours after surgery.
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