We report a case of pituitary apoplexy resulting in right internal carotid artery occlusion accompanied by hemiplegia and lethargy. A 43-yr-old man presented with a sudden onset of severe headache, visual disturbance and left hemiplegia. Investigations revealed a nodular mass, located in the sella and suprasellar portion and accompanied by compression of the optic chiasm. The mass compressed the bilateral cavernous sinuses, resulting in the obliteration of the cavernous portion of the right internal carotid artery. A border zone infarct in the right fronto-parietal region was found. Transsphenoidal tumor decompression following conservative therapy with fluid replacement and steroids was performed. Pathological examination revealed an almost completely infarcted pituitary adenoma. The patient's vision improved immediately after the decompression, and the motor weakness improved to grade IV+ within six months after the operation. Pituitary apoplexy resulting in internal carotid artery occlusion is rare. However, clinicians should be aware of the possibility and the appropriate management of such an occurrence.
Adult ; Carotid Artery Diseases/*diagnosis/etiology/therapy ; *Carotid Artery, Internal/pathology/surgery ; Diagnosis, Differential ; Embolization, Therapeutic ; Humans ; Magnetic Resonance Angiography ; Male ; Pituitary Apoplexy/complications/*diagnosis ; Tomography, X-Ray Computed

OBJECTIVETo observe the intervening effects of Xuezhikang Capsule (XZK) on levels of blood lipid and other related indices in patients with different Chinese medical syndrome patterns of non-alcoholic fatty liver disease complicated carotid atherosclerosis (NAFLD-CAS), and to seek out the most appropriate pattern to indicate XZK for making guidance of its utilization.

METHODSChinese medical syndrome in 74 patients of NAFLD-CAS were classified into 4 patterns, 34 of Pi-deficiency phlegm-dampness pattern (A), 24 of dampness-heat accumulation pattern (B), 12 of phlegm-stasis intertwined pattern (C), and 4 of Gan-Shen yin-deficiency pattern (D). Excepting those of pattern D were excluded due to too small samples, all patients were treated with XZK for 3 months. Blood levels of blood lipids, including triglyceride (TG), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C), as well as high-sensitivity C-reactive protein (hs-CRP), and tumor necrosis factor alpha (TNF-alpha) were detected and compared before and after treatment.

RESULTSThe effective rate of XZK on patients of the three patterns, in A-C order, was 97.06%, 91.67%, 91.67%, respectively, with the optimal overall efficacy showed on pattern A. All the indices detected significantly decreased after treatment in all three patterns (P < 0.01), among them, excepting the difference of TG level between groups showed no significance (P > 0.05), the decrements of others were more significant in pattern A than in other two patterns (P < 0.05 or P < 0.01).

CONCLUSIONXZK could reduce the levels of blood lipids, hs-CRP and TNF-alpha in NAFLD-CAS patients, and the Pi-deficiency phlegm-dampness syndrome pattern was the optimal indication of XZK treatment.

Aged ; Carotid Artery Diseases ; complications ; diagnosis ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Fatty Liver ; complications ; diagnosis ; drug therapy ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Non-alcoholic Fatty Liver Disease ; Phytotherapy ; Treatment Outcome

No abstract available.
Aged ; Anti-Inflammatory Agents/therapeutic use ; Carotid Artery Diseases/*complications/diagnosis/therapy ; Cerebral Angiography/methods ; Diagnosis, Differential ; Female ; Glucocorticoids/therapeutic use ; Humans ; Hydrocortisone/therapeutic use ; Hypopituitarism/diagnosis/*etiology/therapy ; Intracranial Aneurysm/*complications/diagnosis/therapy ; Magnetic Resonance Imaging ; Plasma Substitutes/administration & dosage ; Predictive Value of Tests ; Prednisolone/therapeutic use ; Sella Turcica ; Thyroid Hormones/therapeutic use ; Tomography, X-Ray Computed ; Treatment Outcome