首页> 中文期刊> 《中华神经医学杂志》 >二例外伤性垂体柄中断综合征的临床探讨

二例外伤性垂体柄中断综合征的临床探讨

摘要

Objective To analyze the clinical characteristics of pituitary stalk interruption syndrome (PSIS) for its better understanding. Methods The clinical manifestations and endocrine alterations were analyzed retrospectively in 2 PSIS cases, and the literatures concerning this disease were reviewed. Results Both of the 2 adult patients had definite history of head injuries, and one of them exhibited nervous system sequelae. The diagnoses remained erroneous for 15 and 2 years, respectively. This disease was characterized by gradual clinical hypopituitarism, and both of the 2 patients were admitted for pituitary crisis, which occurred for several times in 1 case;neither of the patients had diabetes insipidus. Endocrine examination suggested hypofunction of the thyroid gland, sexual gland and adrenal glands due to hypopituitarism. Magnetic resonance imaging revealed pituitary atrophy, pituitary stalk interruption and posterior lobe hyperintensity in the infundibular recess. So far only 2 juvenile cases of traumatic PSIS were reported, which had distinct differences from early-onset PSlS and from simple traumatic hypopituitarism without pituitary stalk interruption. Conclusion Traumatic PSIS is a rare clinical entity. In cases of endocrine alterations following head injury, traumatic PSIS might be suspected and appropriate treatment should be administered.%目的 探讨外伤性垂体柄中断综合征(PSIS)的临床特点.方法 回顾性总结2例外伤性PSIS患者的临床表现及内分泌改变,并结合国内外文献分析其临床特点.结果 2例均为成年患者,有明确的头部外伤史,其中1例有神经系统后遗症;误诊分别为15年和2年,临床上以逐渐出现垂体功能低下为表现,均因发生垂体危象而住院,其中1例多次发生垂体危象;无尿崩症表现;内分泌功能检查提示为垂体功能低下导致甲状腺、性腺、肾上腺功能低下;MRI显示垂体萎缩,垂体柄中断消失,漏斗隐窝处可见后叶高信号.此种外伤性PSIS与早年发病的PSIS有明显不同,与单纯颅脑外伤引起的无垂体柄中断的垂体功能低下亦有显著不同.结论 外伤性PSIS为一种罕见疾病,头颅外伤后出现内分泌临床改变时应注意该病的可能并给予适当治疗.

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