Pediatric ischemic stroke from an apoplectic prolactinoma

Rebecca A. Kasl, Joshua Hughes, Anthony M. Burrows, Fredric B. Meyer

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Introduction: Pediatric pituitary neoplasms and associated pituitary apoplexy are uncommon. There are few reports in pediatric patients of pituitary apoplexy causing focal arterial compression or diffuse vasospasm resulting in cerebral infarction, and the acute, focal neurological deficits associated with stroke differ from the typical presentation of an apoplectic pituitary tumor. We report the first case of a teenage female with an apoplectic macroprolactinoma presenting with stuttering cerebral infarction secondary to compression of the internal carotid artery (ICA). Case: A 14-year-old female was transferred from an outside facility after presenting with right hand paresthesias and word-finding difficulty that eventually progressed to include right upper extremity weakness and mental status changes. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed an apoplectic macroprolactinemia and diffusion-weighted imaging showed acute stroke in the left anterior and middle cerebral artery distributions. Evaluation of the cerebral vasculature with MRA showed focal compression of the left supraclinoid ICA. Despite prompt surgical decompression, the patient developed right lower extremity weakness in addition to her other deficits though her deficits improved after inpatient rehabilitation. Conclusions: In the pediatric population, there is only one other case of pituitary apoplexy presenting with stroke, which was secondary to vasospasm. We present the first case of pituitary apoplexy presenting with stroke secondary to ICA compression. Though rare, it is important to consider that pituitary apoplexy may present with non-classical symptoms such as ischemic stroke even in pediatric patients.

Original languageEnglish (US)
Pages (from-to)1387-1392
Number of pages6
JournalChild's Nervous System
Volume31
Issue number8
DOIs
StatePublished - Aug 27 2015

Fingerprint

Pituitary Apoplexy
Prolactinoma
Stroke
Pediatrics
Internal Carotid Artery
Cerebral Infarction
Pituitary Neoplasms
Anterior Cerebral Artery
Surgical Decompression
Stuttering
Paresthesia
Middle Cerebral Artery
Patient Rights
Upper Extremity
Inpatients
Lower Extremity
Rehabilitation
Hand
Tomography
Magnetic Resonance Imaging

Keywords

  • Apoplexy
  • Pediatric
  • Pituitary adenoma
  • Prolactinoma
  • Stroke

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

Cite this

Kasl, R. A., Hughes, J., Burrows, A. M., & Meyer, F. B. (2015). Pediatric ischemic stroke from an apoplectic prolactinoma. Child's Nervous System, 31(8), 1387-1392. https://doi.org/10.1007/s00381-015-2712-8

Pediatric ischemic stroke from an apoplectic prolactinoma. / Kasl, Rebecca A.; Hughes, Joshua; Burrows, Anthony M.; Meyer, Fredric B.

In: Child's Nervous System, Vol. 31, No. 8, 27.08.2015, p. 1387-1392.

Research output: Contribution to journalArticle

Kasl, RA, Hughes, J, Burrows, AM & Meyer, FB 2015, 'Pediatric ischemic stroke from an apoplectic prolactinoma', Child's Nervous System, vol. 31, no. 8, pp. 1387-1392. https://doi.org/10.1007/s00381-015-2712-8
Kasl, Rebecca A. ; Hughes, Joshua ; Burrows, Anthony M. ; Meyer, Fredric B. / Pediatric ischemic stroke from an apoplectic prolactinoma. In: Child's Nervous System. 2015 ; Vol. 31, No. 8. pp. 1387-1392.
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