Open Access
J Neurol Surg Rep 2015; 76(02): e205-e210
DOI: 10.1055/s-0035-1554909
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Pituitary Apoplexy After Intravitreal Injection of Vascular Endothelial Growth Factor Inhibitor: A Novel Complication

Rebecca A. Kasl
1   Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee, United States
,
Heather M. Kistka
1   Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee, United States
,
Justin H. Turner
2   Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee, United States
,
Jessica K. Devin
3   Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, United States
,
Lola B. Chambless
4   Division of Neurological Surgery, Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee, United States
› Author Affiliations
Further Information

Publication History

05 September 2014

09 April 2015

Publication Date:
24 August 2015 (online)

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Abstract

Pituitary adenomas are common in the general population. They can be complicated by intratumoral hemorrhage, otherwise known as apoplexy, which frequently presents with neurologic deficits that may necessitate urgent surgical decompression. Many risk factors for pituitary apoplexy have been suggested in the literature. We present a case of symptomatic apoplexy in a woman following the intravitreal administration of the vascular endothelial growth factor (VEGF) inhibitor ranibizumab. Ophthalmoplegia resolved and visual acuity significantly improved following gross total resection of the tumor via an endoscopic endonasal surgical approach. The association between intravitreal injection of a VEGF inhibitor and pituitary apoplexy has not been previously described, but physicians performing these procedures should be aware of this potential complication.