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Risk factors for brain infarction in patients with Cushing's disease. Case reports

T Mizokami1, K Okamura, K Sato

  • 1Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.

Angiology
|October 1, 1996
PubMed

Insights

Cushing's disease patients face increased risk of brain infarction due to hypercortisolemia, pituitary irradiation, and hypopituitarism. Early diagnosis and treatment are crucial for preventing cerebrovascular complications.

Area of Science:

  • Neuroendocrinology
  • Cerebrovascular Medicine

Background:

  • Cushing's disease is a rare endocrine disorder characterized by prolonged exposure to excess cortisol.
  • Cerebrovascular complications are a known, though not fully understood, risk in Cushing's disease patients.

Observation:

  • Two female patients developed brain infarction during or after treatment for Cushing's disease.
  • Arteriosclerotic changes in cerebral vessels progressed despite treatment and hormone replacement therapy.
  • One patient with Nelson's syndrome exhibited severe cerebrovascular changes, particularly near the irradiated area.

Findings:

  • Hypercortisolemia, pituitary irradiation, and posttreatment hypopituitarism are identified as potential risk factors for brain infarction.
  • Biochemical remission was achieved over a decade after disease onset in the observed cases.

Implications:

  • Emphasizes the need for vigilant monitoring of cerebrovascular health in Cushing's disease patients.
  • Suggests that comprehensive management strategies should address both endocrine control and vascular risk factors.
  • Highlights the importance of early diagnosis and timely intervention to mitigate the risk of stroke in this population.

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