下垂体卒中の1例

A case of pituitary apoplexy

　58歳女性が5日前に左眼の視力低下を自覚し，球後視神経炎として紹介された。視力は右1.0左眼0.02であった。眼底には異常所見はなかった。視野は左眼に求心性狭窄があった。MRI検査で脳下垂体に2cm大の出血と思われる塊があり，下垂体卒中と診断された。手術的に摘出された腫瘤は，嫌色素性の良性腺腫と，これからの出血であった。手術後に視野が正常化し，3か月後に左眼視力は0.9に回復した。下垂体卒中による視力障害が早期治療で回復しうることを示す例である。

A 58-year-old female noted acute visual loss in her left eye 5 days before. She was referred to us as presumed retrobulbar neuritis. Her visual acuity was 1.0 right and 0.02 left. Fundus findings were normal. Constriction of visual field was present in the left eye. Magnetic resonance imaging (MRI) showed a tumor of about 2 cm in size in the pituitary area, leading to the diagnosis of pituitary apoplexy. Surgically removed tumor was identified as aerophobe benign adenoma with hemorrhage. The visual field normalized immediately after surgery. The left visual acuity recovered to 0.9 3 months later. This case illustrates that early surgery may lead to recovery of vision due to pituitary apoplexy.