急性Sheehan综合征合并颅内压升高在一位产后妇女中的共同表现

R. Gomes
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摘要

希恩综合征(SS)或垂体坏死是严重产后出血的罕见并发症。根据组织破坏的程度,它可能会立即或几年后引起垂体功能减退。希恩综合征虽然罕见,但在像我们这样的发展中国家,它仍然是垂体功能减退症最常见的原因之一。并发感染和服用甲状腺素加重了她的皮质类固醇功能不全。颅内高压(IH)表现为双侧视盘肿胀,视力下降,双侧第六神经麻痹,意识受损。颅内高压(IH)与原发性肾上腺皮质功能不全或皮质类固醇戒断引起的皮质醇分泌不足有关。作者描述了一例患有急性SS的IH年轻女性,她在下子宫剖宫产术后第3天出现急性严重症状性低钠血症,并伴有产后出血。激素替代治疗IH的临床表现
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Co-presentation of Acute Sheehan Syndrome with Raised Intracranial Pressure in a Post-partum Lady
Sheehan’s syndrome (SS) or necrosis of pituitary gland is a rare complication of severe postpartum hemorrhage. It may cause hypopituitarism immediately or several years later, depending on the degree of tissue destruction. Sheehan’s syndrome though rare is still one of the commonest causes of hypopituitarism in developing countries like ours. The presence of an intercurrent infection and administration of thyroxine exacerbated her corticosteroid insufficiency. Intracranial hypertension (IH) manifested as bilateral optic disc swelling with reduced visual acuity, bilateral sixth nerve palsies, and impaired consciousness. Intracranial hypertension (IH) has been associated with hypocortisolism caused by either primary adrenocortical insufficiency or corticosteroid withdrawal. The author describes a case of a young lady with IH with acute SS who presented on 3rd day postpartum after lower uterine cesarean section with acute severe symptomatic hyponatremia which was complicated by postpartum hemorrhage. The clinical manifestations of IH resolved with corticosteroid replacement
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