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Risk Factors for Brain Infarction in Patients with Cushing's Disease

Case Reports

Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan

Ken Okamura

Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan

Kaori Sato

Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan

Takeo Kuroda

Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan

Seizo Sadoshima

Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan

Masatoshi Fujishima

Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan

Two women aged 51 and 52 years old, respectively, developed a brain infarction before and after undergoing treatment for Cushing's disease. A biochemical remission was obtained more than ten years after the onset of signs or symptoms of Cushing's disease. The arteriosclerotic changes of the cerebral vessels progressed even during replacement therapy for posttreatment hypopituitarism after they underwent either ablative surgery or radiotherapy. One patient, who showed the signs of Nelson's syndrome, demonstrated severe progressive cerebrovascular sclerotic changes, especially around the irradiated site. It is thus suggested that hypercortisolemia, external pituitary irradiation, and post treatment hypopituitarism may be risk factors for brain infarction. The early diagnosis and adequate treatment are therefore important to prevent cerebrovascular complica tions in patients with Cushing's disease.

Angiology, Vol. 47, No. 10, 1011-1017 (1996)
DOI: 10.1177/000331979604701010


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