Minimally Invasive Pituitary Surgery in a Hemorrhagic Necrosis of Adenoma During Pregnancy

J. Gondim; F. Ramos Jr; I. Pinheiro; M. Schops; O. I. Tella Jr

doi:10.1055/s-2003-40734

min - Minimally Invasive Neurosurgery, Table of Contents

Minim Invasive Neurosurg 2003; 46(3): 173-176
DOI: 10.1055/s-2003-40734

Case Report

Minimally Invasive Pituitary Surgery in a Hemorrhagic Necrosis of Adenoma During Pregnancy

J. Gondim¹ , F. Ramos Jr.¹ , I. Pinheiro² , M. Schops³ , O. I. Tella Jr.⁴

¹Department of Neurosurgery, General Hospital of Fortaleza, Brazil
²Department of Oto-rhino-laryngology, General Hospital of Fortaleza, Brazil
³Department of Anesthesiology, Federal University of Ceará (UFC), Brazil
⁴Department of Neurosurgery, Federal University of São Paulo (UNIFESP), Brazil

Abstract

A 29-year-old woman with a prolactin microadenoma was under good control with bromocriptine (BCP) therapy until she became pregnant, when the treatment was stopped. During the third trimester of pregnancy the patient presented a unilateral visual loss and intermittent headaches. BCP was restarted and one week later she developed a complete ophthalmoplegia on the other side. The patient was submitted to an endoscopic transnasal transeptal resection of a hematoma and tumoral tissue in the pituitary region. One month after surgery, at 39 weeks of gestation, the patient spontaneously delivered a healthy girl weighing 3 kg, with an Apgar score of 9 and 10 at five minutes. This is the first case in the literature of a pregnant woman with second and third cranial nerve lesions, submitted to minimally invasive neuroendoscopic transnasal transsphenoidal approach in the third trimester of pregnancy.

Key words

Pregnancy - pituitary apolexy - endoscope - minimally invasive

Full Text

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Dr. J. Gondim

Instituto de Neurologia

1805 Pereira Filgueiras Street

Fortaleza

Brazil 60.181-560

Phone: +55-85-265-5768

Fax: +55-85-265-5768

Email: jagondim@secrel.com.b