Развитие аневризмы внутренней сонной артерии на фоне успешного консервативного лечения пролактиномы

Введение. Вопрос о сочетании аденом гипофиза и интракраниальных аневризм достаточно широко отражен в современной литературе. По данным различных авторов, распространенность подобного сочетания составляет в среднем 9 %. В основном встречается сочетание гормонально активных аденом гипофиза с аневризмами передней циркуляции: 69 % подобных аневризм происходят из сонной артерии. Работ, представляющих развитие аневризм после лечения пролактином, нами не найдено.

Цель работы – анализ и демонстрация лечения пациентов с развившейся аневризмой внутренних сонных артерий (ВСА) на фоне успешной консервативной терапии пролактиномы.

Материалы и методы. В данной статье проведен обзор литературы и представлены два клинических наблюдения пациентов, у которых развились аневризмы ВСА после успешного консервативного лечения пролактином.

Результаты. В обоих описанных случаях аневризмы ВСА с интраселлярным распространением развились после успешного консервативного лечения крупных инвазивных пролактином. В обоих случаях была выполнена окклюзия ВСА, а в одном случае также был наложен экстра‑интракраниальный микроанастомоз.

Заключение. Представленные клинические случаи свидетельствуют о возможном прямом деструктивном воздействии опухолевой ткани на стенки сосудов. В настоящее время всем больным с аденомами, прорастающими в кавернозный синус, целесообразно проводить компьютерную томографическую ангиографию.

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