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Medical Science Monitor Basic Research


Pituitary apoplexy after coronary artery bypass grafting surgery

Marek Czajkowski, Wojciech Dąbrowski, Ziemowit Rzecki, Jadwiga Biernacka

CaseRepClinPractRev 2005; 6:182-185

ID: 428854

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Background: The pituitary apoplexy is a very rare complication of cardiac surgery. The multi-stage, complex character of such operations and modes of treatment may contribute to intrapituitary bleeding. Clinical symptoms of pituitary apoplexy are typically varied and relieved by urgent transsphenoidal decompression. Early diagnosis and treatment of this pathology usually results in a good outcome. Case Report: The case reports occult pituitary apoplexy after myocardial revascularization with extracorporeal circulation. The headache and visual defects were the main symptoms of this pathology after the wake up. The jugular vein bulb saturation was measured during the procedure and it’s decrease was observed during extracorporeal circulation and in the early postoperative period. An early diagnosis with spiral CT resulted in immediate transfer for neurosurgical treatment.Conclusions: The pituitary apoplexy is a very rare complication of on-pump coronary artery bypass grafting. Any visual defect and headache after such procedures should be immediately diagnosed to exclude a pituitary pathology. The computed tomography or MRI are the management of choice. The measurement of blood vein bulb saturation is usefulness in prediction of brain damage in patients undergoing CABG.

Keywords: pituitary apoplexy, CABG, visual defect, jugular bulb vein saturation