J Cerebrovasc Endovasc Neurosurg.  2024 Jun;26(2):210-215. 10.7461/jcen.2023.E2023.08.005.

Unilateral caudate infarct following pituitary adenoma resection

• Wong-Achi X
• Rodriguez-Hernández L
• Herrera-Castro J
• Sangrador-Deitos M
• Gómez-Amador JL
• García-González U

• KMID: 2556984
• DOI: http://doi.org/10.7461/jcen.2023.E2023.08.005

Abstract

Cerebral ischemic complications after pituitary surgery are not frequently reported. Multiple mechanisms have been proposed, including vasospasm, and delayed cerebral ischemia resulting from postoperative subarachnoid bleeding. Given the unknown etiology of vasospasm following these situations, little is known about its prevention. Through a case report and bibliographic review, the authors warn about the importance of recognizing key signs postoperatively that could indicate increased risk for cerebral vasospasm and must be recognized in a timely manner, with appropriate treatment strategies implemented once these symptoms present.

Keyword

Pituitary adenoma; Postoperative complications; Ischemia; Subarachnoid hemorrhage; Caudate nucleus

Figure

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  Fig. 1. (A, B) Axial and coronal T1 MRI sequence showing tumor in sellar area with heterogeneous characteristics (24×23×18 mm); (C) Sagittal T2 MRI sequence showing the suprasellar extension of the tumor. MRI, magnetic resonance imaging

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  Fig. 2. CT scan in the immediate postoperative period showing total resection of the tumor and subarachnoid bleeding that extends from the surgical site towards the left sylvian and interhemispheric fissure, modified Fisher 3. CT, computed tomography

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  Fig. 3. PO day five CT scan showing hypodensity in the head of the left caudate nucleus, consistent with area of ischemia. PO, postoperative; CT, computed tomography

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