RESUMO
We present the case of a female patient who developed chiasmatic apoplexy and menstrual alterations. CT scanning showed a suprasellar hemorrhage. She underwent surgery with the presumptive diagnosis of pituitary tumor. At surgery, we find a brown-grayish lesion involving left optic nerve and chiasm. Cavernous angioma was diagnosed by histopathology. Cavernous angiomas constitute nearly 15% of all central nervous system vascular malformations. Location at the optic pathway is very rare, but must to be ruled out in the diagnosis of a patient with chiasmatic and/or optic apoplexy. Surgery is useful in preventing worsening of the previous deficit or a new visual defect.
Assuntos
Hemangioma Cavernoso/complicações , Quiasma Óptico/irrigação sanguínea , Neoplasias do Nervo Óptico/complicações , Acidente Vascular Cerebral/etiologia , Adenoma/diagnóstico , Adulto , Craniotomia , Diagnóstico Diferencial , Emergências , Feminino , Cefaleia/etiologia , Hemangioma Cavernoso/diagnóstico por imagem , Hemangioma Cavernoso/cirurgia , Humanos , Microcirurgia , Quiasma Óptico/diagnóstico por imagem , Quiasma Óptico/cirurgia , Neoplasias do Nervo Óptico/diagnóstico por imagem , Neoplasias do Nervo Óptico/cirurgia , Apoplexia Hipofisária/diagnóstico , Neoplasias Hipofisárias/diagnóstico , Tomografia Computadorizada por Raios X , Transtornos da Visão/etiologia , Campos VisuaisRESUMO
The acetylcholine, dopamine, serotonin and other neurotransmitters may be reduced in the subcommissural regions even in the early stages of Alzheimer's disease(AD), due to hypoperfusion of the anterior perforating and anterior choroidal arteries. This hypothesis was confirmed after the transplant of omental tissue on the optic chiasma, carotid crotch and anterior perforated space in a woman with moderate AD. Neurological improvement was better in the first week after the surgery than in the following months.
Assuntos
Doença de Alzheimer/cirurgia , Omento/transplante , Doença de Alzheimer/diagnóstico por imagem , Doença de Alzheimer/fisiopatologia , Circulação Cerebrovascular/fisiologia , Plexo Corióideo/fisiologia , Círculo Arterial do Cérebro/fisiologia , Feminino , Humanos , Pessoa de Meia-Idade , Quiasma Óptico/irrigação sanguínea , Quiasma Óptico/cirurgia , Tomografia Computadorizada por Raios XRESUMO
The authors are presenting the first description of the surgical treatment of an illness that is characterized by severe campimetric alterations (concentric reduction) in patients carrying prolactin-secreting microadenoma. Eleven demonstrative cases are presented.