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Bilateral stroke following pituitary apoplexy
1Cecilie Vogt Clinic for Neurology in the Helios-Klinikum Berlin-Buch, Charité - University Medicine Berlin, Charitéplatz 1, 10117 Berlin, Germany.
Summary
Pituitary apoplexy is a rare complication, especially after aggressive anticoagulation for myocardial infarction. This case highlights the risks of potent blood thinners in patients with pituitary adenomas.
Area of Science:
- Endocrinology
- Neurology
- Cardiology
Background:
- Pituitary apoplexy, a rare endocrine emergency, involves sudden hemorrhage or infarction of the pituitary gland.
- Pituitary macroadenomas are tumors that can predispose individuals to apoplexy.
- Aggressive anticoagulation and antiplatelet therapies are standard for acute myocardial infarction.
Observation:
- A 59-year-old male with a known pituitary macroadenoma presented with acute myocardial infarction.
- The patient received coronary angioplasty and was treated with aspirin, clopidogrel, and full-dose enoxaparin.
- Following treatment, he developed pituitary apoplexy, leading to bilateral internal carotid artery compression.
Findings:
- The pituitary apoplexy resulted in infarction of both the anterior and middle cerebral hemispheres.
- The patient experienced a fatal outcome due to the extensive cerebral infarction.
- This case underscores the complex interplay between pituitary pathology and cardiovascular treatment.
Implications:
- Administering aggressive anticoagulative and antiplatelet therapy in patients with known pituitary adenomas presents significant challenges.
- Careful consideration of risks versus benefits is crucial when managing cardiovascular events in patients with pituitary tumors.
- Further research may be needed to establish safer treatment protocols for such complex cases.
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