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Pituitary Tumor

内分泌

关键词内分泌 临床研究术语 垂体

词汇介绍

拓展阅读

解析

Pituitary   英 /pɪˈtjuːɪtəri/   美 /pɪˈtuːəteri/

释    义   n. (脑)垂体

               adj. 脑垂体的;脑垂体分泌失调引起的

例    句   Your pituitary gland pumps this stuff out a part of the stress response. 你的脑垂体释放这种物质作为对压力反应的一部分。

 

Tumor   英 /'tju:mə(r)/   美 /'tjʊmɚ/

释    义   n. 肿瘤;肿块;赘生物

例    句   So antiangiogenesis will be an efficient method in the inhibition of the growth and metastasis of tumor. 所以抗血管生成将是一种很有希望的对抑制肿瘤生长和转移的有效方法。

概述

垂体瘤是在垂体中异常生长的肿瘤,某些垂体肿瘤会导致过多的激素调节人体的重要功能,一些垂体瘤可导致垂体产生较低水平的激素。大多数垂体肿瘤是非癌性(良性)生长。腺瘤残留在垂体或周围组织中,不会扩散到身体的其他部位。与肿瘤压力有关的体征和症状相关症状可能包括:头痛;视力丧失,特别是周围视力丧失。与激素水平变化有关的症状垂体功能正常的肿瘤会导致激素过度产生。垂体中不同类型的功能性肿瘤会引起特定的体征和症状,有时甚至压迫症状与功能失调症状均出现。大肿瘤可能会导致荷尔蒙缺乏,体征和症状包括:恶心和呕吐;

Pipeline embolization for an iatrogenic intracranial internal carotid artery pseudoaneurysm after transsphenoidal pituitary tumor surgery: Case report and review of the literature复制标题

经蝶垂体瘤术后医源性颅内颈内动脉假性动脉瘤的管道栓塞治疗: 病例报告及文献复习

发表时间:2019-09-10

影响因子:1.5

作者: Yasuhiko Nariai

期刊:Interv Neuroradiol

This case indicates the prospective possibility of using flow-diverting stents for the treatment of pseudoaneurysms, especially for those caused following TSS. Flow-diverting stents can enable us to treat the pseudoaneurysms with preservation of the parent artery in a less invasive manner. In TSS, life-threatening complications such as hemorrhage from ICA injuries can arise. The cavernous segments of the ICA are at risk during surgical exploration of the pituitary gland such as when removing the sellar floor, opening the sellar dura, and resecting tumors. The reported incidence of ICA injuries during TSS for pituitary tumors ranges between 0.55 and 1.1%. ICA pseudoaneurysms resulting from iatrogenic injuries during TSS are similar to blood blister-type aneurysms histologically (indicating focal artery laceration), and geographically (occurring at non-branching sites of the ICA), with the possibility for rapid enlargement and rupture with a 30–50% reported mortality rate. Although shrinkage and spontaneous resolution of intracranial pseudoaneurysms have been reported, clinical series have reported rupture rates of up to 60% prior to definitive treatment. In a review by Alzhrani et al., the time of diagnosis of pseudoaneurysms after TSS injuries ranges from 2 days to 10 years postoperatively. Patients with ICA pseudoaneurysms present with cranial neuropathy, carotid-cavernous fistula (CCF), pituitary apoplexy, or epistaxis. Prompt angiography after initial management of acute bleeding with nasal packing allows assessment of whether there is ongoing hemorrhage and can be used to identify the presence of pseudoaneurysms or CCF. Among Michael et al.’s cohort, 23% of patients with cavernous carotid pseudoaneurysm after TSS did not show evidence of vascular injury or hemorrhage during the operation, implying likely subtle carotid injuries that were unrecognized during the surgery. Patients with a history of TSS should be immediately inspected for iatrogenic vascular abnormalities once they present with epistaxis, visual impairment, external ophthalmoplegia, or bruit, even if there is no evidence of injury in the ICA.

译文

这种情况表明使用分流支架治疗假性动脉瘤的潜在可能性,特别是对于那些由TSS引起的假性动脉瘤。导流支架可以使我们以较小的侵入性方式治疗假性动脉瘤并保留母动脉。在TSS中,可能会发生危及生命的并发症,例如ICA损伤引起的出血。 ICA的海绵状节段在垂体腺的外科探查过程中处于危险之中,例如,在移除鞍底,打开鞍硬脑膜和切除肿瘤时。据报道,垂体肿瘤在TSS期间ICA损伤的发生率在0.55%至1.1%之间。 TSS期间因医源性伤害而导致的ICA假性动脉瘤在组织学上(表明局灶性动脉撕裂)和地理上(在ICA的非分支部位)都类似于血泡型动脉瘤,并可能在30–30岁时迅速扩大并破裂。报告的死亡率为50%。尽管已经报道了颅内假性动脉瘤的萎缩和自发消退,但临床系列报道在确定的治疗之前破裂率高达60%。在Alzhrani等人的评论中,TSS损伤后假性动脉瘤的诊断时间为术后2天至10年。 ICA假性动脉瘤患者表现为颅神经病变,颈动脉海绵状瘘(CCF),垂体中风或鼻epi。鼻腔填塞急性出血的初始处理后,立即进行血管造影可以评估是否存在持续的出血,并可用于识别假性动脉瘤或CCF的存在。在Michael等人的研究组中,TSS后发生海绵状颈动脉假性动脉瘤的患者中有23%没有显示出手术过程中血管损伤或出血的迹象,这暗示了可能在手术期间无法识别的细微颈动脉损伤。具有TSS病史的患者一旦出现鼻出血,视力障碍,外部眼肌麻痹或瘀伤,即使没有ICA损伤的证据,也应立即检查是否存在医源性血管异常。