J Korean Neurosurg Soc.  1997 Mar;26(3):452-457.

A Case of Cavernous ICA Occlusion after Radiation Therapy in Pituitary Adenoma

• Kim ED
• Rim BC
• Min KS
• Lee MS
• Kim YG
• Kim DH

Abstract

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.

Keyword

Pituitary adenoma; Radiation therepy; Delayed complication; Carotid stenosis; Cerebral angiography

MeSH Terms

Amaurosis Fugax
Arteries
Carotid Artery Diseases
Carotid Artery, Internal
Carotid Stenosis
Cerebral Angiography
Constriction, Pathologic
Female
Humans
Hypopituitarism
Infarction
Ischemic Attack, Transient
Middle Aged
Pituitary Neoplasms*
Seizures