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題 名 | Acute Painful Oculomotor Nerve Paresis Caused by Pituitary Apoplexy--a Case Report=由腦下垂體出血引發之疼痛性第三腦神經麻痺--病例報告 |
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作 者 | 陳幸宜; 蔡榮坤; 洪純隆; | 書刊名 | The Kaohsiung Journal of Medical Sciences |
卷 期 | 15:7 1999.07[民88.07] |
頁 次 | 頁437-440 |
分類號 | 416.291 |
關鍵詞 | 腦下垂體出血; 第三腦神經麻痺; Pituitary adenoma; Apoplexy; Painful ophthalmoplegia; |
語 文 | 英文(English) |
中文摘要 | 在一個典型的腦下垂體出血,一個病人自己本身可能知道或是不知道已有腦下垂體腫瘤,可突然間發生嚴重的頭痛,這種頭痛可能是眼窩後方的,額部的,額顳部,或是廣泛的,而且可能與頸部僵硬,頸部疼痛,或兩者同時有關。眼外肌麻痺可能在頭痛之後數小時發生。在本篇文章我們報告一個腦下垂體出血之病例,一開始以急性瞳孔侵犯之第三腦神經麻痺併有頭痛及眼窩之疼痛。緊急之影像學檢查顯示腦下垂體腫瘤併有出血,其中並且侵犯到右側海綿竇。腦下垂體被診斷出來,經靜脈給予大量類固醇之後二天,動眼神經麻痺有恢復之跡象。此病人之後接受腦下垂體腫瘤切除,而且在術後其眼外肌麻痺的情形完全恢復。對於急性腦下垂體出血最適當的處理方式目前認為最好的方式仍是給予大量類固醇,特別是在意識狀態或生命有惡化的時候。在這裏我們提供這個罕見的病例,並且討論我們處理之經驗以供參考。 |
英文摘要 | In a typical case of pituitary apoplexy, a patient, who may or may not be known to harbor a pituitary adenoma, suddenly develops a severe headache. The headache may be retro-orbital, frontal, frontotemporal, or diffuse and may be associated with neck stiffness, neck pain, or both. Ophthalmoplegia may develop within a few hours after the onset of headache. Here we report a rare case of one middle-aged female with pituitary apoplexy initially presenting with acute onset of pupil-involved third cranial nerve palsy, headache and peri-ocular pain. Emergent neuroimaging revealed pituitary apoplexy and immediate intravenous corticosteroid was given and third nerve paresis was improved thereafter. Definite tumor removal was done smoothly after steroid treatment and complete recovery of ophthalmoplegia was noted 2 weeks after operation. |
本系統中英文摘要資訊取自各篇刊載內容。