Zhuangzhuang Miao1, Zhuo Zhang1, Juan Chen1, Junwen Wang1, Huaqiu Zhang2, Ting Lei1. 1. Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. 2. Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Electronic address: zhanghq_04@yahoo.com.
Abstract
BACKGROUND: Cushing disease, induced by a pituitary adrenocorticotropic hormone (ACTH)-secreting adenoma, is associated with high risk of stroke. At present, transsphenoidal surgery remains the first line of therapy. Cerebral venous sinus thrombosis (CVST) is an uncommon form of stroke with variable presentations. There are no previous reports of its occurrence in patients with Cushing disease following transsphenoidal surgery. CASE DESCRIPTION: We report a patient with Cushing disease who sustained CVST several days after a second transsphenoidal surgery. With adequate care and treatment, along with timely diagnosis, the patient made a near-complete recovery with only minor sequelae. CONCLUSIONS: In view of the poor outcome of untreated CVST, symptoms such as severe headache, nausea and vomiting, and cerebrospinal fluid leakage after transsphenoidal surgery could be of valuable assistance in early diagnosis, allowing immediate medical intervention with consequent improved prognosis.
BACKGROUND:Cushing disease, induced by a pituitary adrenocorticotropic hormone (ACTH)-secreting adenoma, is associated with high risk of stroke. At present, transsphenoidal surgery remains the first line of therapy. Cerebral venous sinus thrombosis (CVST) is an uncommon form of stroke with variable presentations. There are no previous reports of its occurrence in patients with Cushing disease following transsphenoidal surgery. CASE DESCRIPTION: We report a patient with Cushing disease who sustained CVST several days after a second transsphenoidal surgery. With adequate care and treatment, along with timely diagnosis, the patient made a near-complete recovery with only minor sequelae. CONCLUSIONS: In view of the poor outcome of untreated CVST, symptoms such as severe headache, nausea and vomiting, and cerebrospinal fluid leakage after transsphenoidal surgery could be of valuable assistance in early diagnosis, allowing immediate medical intervention with consequent improved prognosis.
Authors: Katharina Tielking; Silvia Fischer; Klaus T Preissner; Peter Vajkoczy; Ran Xu Journal: Front Mol Neurosci Date: 2019-10-17 Impact factor: 5.639