무균성 뇌수막염으로 오인된 뇌하수체졸증 1예
A Case of Pituitary Apoplexy Misdiagnosed as Aseptic Meningitis
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초록
본 저자들은 뇌수막염 증상으로 오인되어 치료가 지연, 부신 위기 동반으로 악화된 후 진단된 뇌하수체 선종의 뇌하수체졸증 1예를 경험하여, 무균성 뇌수막염이 호전되지 않을 경우에는 드물지만 치명적인 경과를 보일 수 있는 뇌하수체졸증일 가능성을 상기하고자 이를 보고하는 바이다.
Abstract
Pituitary apoplexy is a clinical syndrome caused by an acute ischemic or hemorrhagic vascular accident. Although pituitary apoplexy is an emergency, it is often overlooked because it is rare and presents with various signs and symptoms, including those of neurologic and endocrine disorders. We describe a case of pituitary apoplexy misdiagnosed as aseptic meningitis accompanied by acute-onset headache and nausea, followed by fever. Subsequently, it was revealed as pituitary apoplexy by brain magnetic resonance imaging (MRI) performed when the clinical course worsened and ophthalmoplegia developed. We suggest that pituitary apoplexy be included in the differential diagnosis of patients presenting with headache or signs of meningeal irritation; when there is no clinical improvement, prompt steroid treatment should be started, while considering neurological decompression to prevent neurological sequelae. (Korean J Med 2011;80:102-107)
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