UNASSIGNED: A 38-year-old man underwent endoscopic transsphenoidal surgery for a nonfunctioning pituitary adenoma. The patient experienced mild subarachnoid hematoma during surgery. Three hours after surgery, he developed rightward conjugate eye deviation and complete paralysis of the left upper and lower extremities. Diagnostic imaging revealed cerebral vasospasm in both middle cerebral arteries, and symptoms improved after intra-arterial administration of fasudil hydrochloride.
UNASSIGNED: There is a need for prompt diagnosis and therapeutic intervention when typical symptoms of cerebral vasospasm, such as paralysis, occur at any time during the postoperative course.
■一名38岁的男子接受了无功能垂体腺瘤的内镜经蝶入路手术。患者在手术期间出现轻度蛛网膜下腔血肿。手术后三小时,他出现了向右共轭眼偏斜和左上下肢完全瘫痪。诊断成像显示大脑中动脉的脑血管痉挛,动脉内给予盐酸法舒地尔后症状改善。
■当出现脑血管痉挛的典型症状时,需要及时诊断和治疗干预,比如瘫痪,发生在术后过程中的任何时间。