• World Neurosurg · Oct 2020

    Case Reports

    Posterior Reversible Encephalopathy Syndrome after Transsphenoidal Resection of Pituitary Macroadenoma.

    • Marcus Wong, Sibi Rajendran, Shruti Harish Bindiganavile, Nita Bhat, Andrew G Lee, and David S Baskin.
    • Neurological Institute, Department of Neurosurgery, Houston Methodist Hospital, Houston, Texas, USA. Electronic address: mswong@houstonmethodist.org.
    • World Neurosurg. 2020 Oct 1; 142: 171-175.

    BackgroundPosterior reversible encephalopathy syndrome is manifested by a reversible neurologic deficit such as vision loss, encephalopathy, and a posterior location, typically the occipital lobes. It is commonly thought to be related to acute, severe hypertension.Case DescriptionA 51-year-old woman presented with visual loss for several months, and a suprasellar mass was diagnosed. She underwent transsphenoidal surgery, which was complicated by cerebrospinal fluid leak, and she developed posterior reversible encephalopathy syndrome while undergoing postoperative cerebrospinal fluid drainage via lumbar catheter. Her visual acuity progressed to blindness, but blindness was reversed by discontinuation of lumbar drainage, tight blood pressure control, and high-dose steroid drip.ConclusionsTo our knowledge, this is only the second case of posterior reversible encephalopathy syndrome following transsphenoidal surgery to be reported in the neurosurgical or ophthalmic English language literature.Published by Elsevier Inc.

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