Skip to main content
Log in

Brain and optic chiasmal herniations into sella after cabergoline therapy of giant prolactinoma

  • CASE REPORT
  • Published:
Pituitary Aims and scope Submit manuscript

Abstract

Optic chiasmal herniation following dopamine agonist therapy is a rare complication in patients with giant prolactinomas. But there are a few case reports of brain and chiasmal herniation following medical therapy in such cases. We report a young man who developed secondary visual loss and seizures after 6 months of medical treatment with cabergoline for giant prolactinoma. Magnetic resonance imaging of hypothalamic pituitary region revealed optic chiasmal and frontal lobe herniation into sella. There was marginal improvement in his vision after cabergoline dose reduction. The present case report highlights frontal lobe herniation in conjunction with optic chiasmal herniation as a very rare complication of medical therapy of giant prolactinoma. Different treatment options of this condition are being discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. Ivan G, Szigeti-Csucs N, Olah M, Nagy GM, Goth MI (2005) Treatment of pituitary tumors: dopamine agonists. Endocr 28(1):101–110. doi:10.1385/ENDO:28:1:101

    Article  CAS  Google Scholar 

  2. Jones SE, James RA, Hall K, Kendall-Taylor P (2000) Optic chiasmal herniation—an under recognized complication of dopamine agonist therapy for macroprolactinoma. Clin Endocrinol (Oxf) 53(4):529–534. doi:10.1046/j.1365-2265.2000.01039.x

    Article  CAS  Google Scholar 

  3. Taxel P, Waitzman DM, Harrington JF Jr, Fagan RH, Rothfield NF, Chen HH, Malchoff CD (1996) Chiasmal herniation as a complication of bromocriptine therapy. J Neuroophthalmol 16(4):252–257. doi:10.1097/00041327-199612000-00005

    PubMed  CAS  Google Scholar 

  4. Chuman H, Cornblath WT, Trobe JD, Gebarski SS (2002) Delayed visual loss following pergolide treatment of a prolactinoma. J Neuroophthalmol 22(2):102–106. doi:10.1097/00041327-200206000-00008

    Article  PubMed  Google Scholar 

  5. Raverot G, Jacob M, Jouanneau E, Delemer B, Vighetto A, Pugeat M, Borson-Chazot F (2009) Secondary deterioration of visual field during cabergoline treatment for macroprolactinoma. Clin Endocrinol 70(4):588–592

    Article  CAS  Google Scholar 

  6. Bangash MH, Clarke DB, Holness RO (2006) Brain and chiasmal herniations into sella after medical treatment of prolactinoma. Can J Neurol Sci 33(2):240–242

    PubMed  CAS  Google Scholar 

  7. Kaufman B, Tomsak RL, Kaufman BA, Arafah BU, Bellon EM, Selman WR et al (1989) Herniation of the suprasellar visual system and third ventricle into empty sellae: morphologic and clinical considerations. AJR Am J Roentgenol 152(3):597–608

    PubMed  CAS  Google Scholar 

  8. Keyaki A, Makita Y, Nabeshima S, Motomochi M, Itagaki T, Tei T (1982) Secondary empty sella syndrome: report of three cases and review of the literature. No Shinkei Geka 10(11):1189–1194

    PubMed  CAS  Google Scholar 

  9. Zona G, Testa V, Sbaffi PF, Spaziante R (2002) Transsphenoidal treatment of empty sella by means of a silastic coil; a technical note. Neurosurgery 51(5):1299–1303. doi:10.1097/00006123-200211000-00032

    Article  PubMed  Google Scholar 

  10. Kubo S, Hasegawa H, Inui T, Tominagas S, Yoshimine T (2005) Endonasal endoscopic transsphenoidal chiasmapexy with silicone plates for empty sella syndrome: technical note. Neurol Med Chir (Tokyo) 45(9):491

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Dinesh Kumar Dhanwal.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dhanwal, D.K., Sharma, A.K. Brain and optic chiasmal herniations into sella after cabergoline therapy of giant prolactinoma. Pituitary 14, 384–387 (2011). https://doi.org/10.1007/s11102-009-0179-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11102-009-0179-x

Keywords

Navigation