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A Case of Apoplexy of Rathke's Cleft Cyst Followed by Cerebral Infarction.

Ohnishi Y, Fujimoto Y, Iwatsuki K, Yoshimine T - Case Rep Neurol Med (2015)

Bottom Line: A 67-year-old woman was found lying on the street unconscious.However, the attending physician did not find this abnormal finding on CT and the patient was discharged the same day.Histopathological findings confirmed a hemorrhagic RCC.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Osaka University Medical School, Suita, Osaka 565-0871, Japan.

ABSTRACT
Rathke's cleft cyst (RCC) apoplexy is a rare clinical entity. We report a case of apoplexy of an RCC followed by cerebral infarction. A 67-year-old woman was found lying on the street unconscious. She had fallen from her motorbike. On referral to our hospital she gradually regained consciousness and presented with no neurological deficits. CT showed a round and slightly hyperdense area in the suprasellar region. However, the attending physician did not find this abnormal finding on CT and the patient was discharged the same day. Thirteen days after the first emergency visit she developed left hemiparesis and dysarthria. CT showed a round hypodense area in the suprasellar region. The change of the density in the suprasellar region on CT suggested the pituitary apoplexy. CT also showed a low density area in the territory of the right middle cerebral artery, which indicated the cerebral infarction. MR angiography revealed poor visibility and stenotic changes of right middle cerebral arteries. Transsphenoidal surgery was performed. Histopathological findings confirmed a hemorrhagic RCC. Postoperative MR angiography showed that the visibility and stenosis of right middle cerebral arteries were recovered. This is the rare case of apoplexy of an RCC followed by cerebral infarction.

No MeSH data available.


Related in: MedlinePlus

MRA revealed less visibility and stenotic changes of right middle cerebral arteries.
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fig3: MRA revealed less visibility and stenotic changes of right middle cerebral arteries.

Mentions: CT on admission showed a round hypodense area in the suprasellar region (Figure 1(b)). The change of the density in the suprasellar region on CT suggested the pituitary apoplexy. Magnetic resonance imaging (MRI) taken 2 days after admission detected isointensity on T1WI and high intensity on T2WI in the suprasellar region (Figure 2). CT also showed a low density area in the territory of the right MCA, which indicated the cerebral infarction (Figure 1(c)). MR angiography (MRA) showed signal loss with poor visibility of distal right middle cerebral arteries (MCAs) (Figure 3). The conservative treatment for cerebral infarction improved her left hemiparesis.


A Case of Apoplexy of Rathke's Cleft Cyst Followed by Cerebral Infarction.

Ohnishi Y, Fujimoto Y, Iwatsuki K, Yoshimine T - Case Rep Neurol Med (2015)

MRA revealed less visibility and stenotic changes of right middle cerebral arteries.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4355814&req=5

fig3: MRA revealed less visibility and stenotic changes of right middle cerebral arteries.
Mentions: CT on admission showed a round hypodense area in the suprasellar region (Figure 1(b)). The change of the density in the suprasellar region on CT suggested the pituitary apoplexy. Magnetic resonance imaging (MRI) taken 2 days after admission detected isointensity on T1WI and high intensity on T2WI in the suprasellar region (Figure 2). CT also showed a low density area in the territory of the right MCA, which indicated the cerebral infarction (Figure 1(c)). MR angiography (MRA) showed signal loss with poor visibility of distal right middle cerebral arteries (MCAs) (Figure 3). The conservative treatment for cerebral infarction improved her left hemiparesis.

Bottom Line: A 67-year-old woman was found lying on the street unconscious.However, the attending physician did not find this abnormal finding on CT and the patient was discharged the same day.Histopathological findings confirmed a hemorrhagic RCC.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Osaka University Medical School, Suita, Osaka 565-0871, Japan.

ABSTRACT
Rathke's cleft cyst (RCC) apoplexy is a rare clinical entity. We report a case of apoplexy of an RCC followed by cerebral infarction. A 67-year-old woman was found lying on the street unconscious. She had fallen from her motorbike. On referral to our hospital she gradually regained consciousness and presented with no neurological deficits. CT showed a round and slightly hyperdense area in the suprasellar region. However, the attending physician did not find this abnormal finding on CT and the patient was discharged the same day. Thirteen days after the first emergency visit she developed left hemiparesis and dysarthria. CT showed a round hypodense area in the suprasellar region. The change of the density in the suprasellar region on CT suggested the pituitary apoplexy. CT also showed a low density area in the territory of the right middle cerebral artery, which indicated the cerebral infarction. MR angiography revealed poor visibility and stenotic changes of right middle cerebral arteries. Transsphenoidal surgery was performed. Histopathological findings confirmed a hemorrhagic RCC. Postoperative MR angiography showed that the visibility and stenosis of right middle cerebral arteries were recovered. This is the rare case of apoplexy of an RCC followed by cerebral infarction.

No MeSH data available.


Related in: MedlinePlus