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目的通过回顾性分析文献,总结有垂体卒中导致的脑梗死的临床特点以增进对之认识。方法通过检索Pubmed、Medline、维普和万方电子数据库,对1950年～2011年间有关垂体卒中所致脑梗死的病例报道进行分析。结果共纳入英文文献19篇,共计患者21例,临床症状主要为意识障碍(81.0%)、突发的头痛(76.2%)、视力障碍(61.9%)、眼外肌麻痹(52.4%)和偏瘫(71.4%)等。52.4%的患者累及多支血管。机械性压迫和血管痉挛是垂体卒中所致脑梗死的主要机制。16例患者接受了经蝶或经颅手术治疗,接受急诊手术的7例中有4例(57.1%)患者出现死亡,明显高于择期手术患者(P<0.05)。结论垂体卒中所致脑梗死临床症状危重,预后较差,急诊手术的死亡风险较大。
Objective To retrospectively analyze the literature and summarize the clinical features of cerebral infarction caused by pituitary apoplexy to promote their understanding. Methods PubMed, Medline, VIP and Wanfang electronic databases were searched to report the cases of cerebral infarction caused by pituitary apoplexy from 1950 to 2011. Results A total of 19 articles were included in the English literature. The total number of patients was 21 with clinical symptoms of disturbance of consciousness (81.0%), sudden headache (76.2%), visual impairment (61.9%), extraocular muscle paralysis (71.4%) and so on. Fifty-two percent of patients had multiple vessels. Mechanical compression and vasospasm are the main mechanisms of cerebral infarction caused by pituitary apoplexy. Of the 16 patients who underwent transurethral or transcranial surgery, 4 (57.1%) of 7 patients undergoing emergency surgery experienced death, significantly higher than those in elective surgery (P <0.05). Conclusions The clinical symptoms of cerebral infarction caused by pituitary apoplexy are critically ill with poor prognosis. The risk of death from emergency surgery is relatively high.