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Adolescent girls have menstrual disorders and vision loss, and the culprit is in the brain

Adolescent girls "menstrual disorders" for more than 2 years, but also appeared vision loss, dizziness, nausea, and even fainted for no reason, all because of a tumor in her head.

A few days ago, neurosurgery experts from Hunan Provincial People's Hospital successfully surgically removed this "time bomb" for her.

Adolescent girls have menstrual disorders and vision loss, and the culprit is in the brain

【Anterior view of the pituitary gland (Zhang Xiaoquan painting)】

Xiaowen (pseudonym), a 19-year-old native of Miluo, Hunan, began to have an extended menstrual cycle about 2 years ago, and only came to menstrual leave every two or three months; in the past year, the "big aunt" simply did not come, and was diagnosed with "menstrual disorders" in the hospital.

After taking the medicine prescribed by the doctor, there was a menstrual holiday; but as long as the drug was stopped, the "great aunt" did not come again.

A month ago, her eyesight deteriorated, her phone was blurry, and she had dizziness, headaches, nausea, vomiting, fatigue and even fainting.

Adolescent girls have menstrual disorders and vision loss, and the culprit is in the brain

[Preoperative head CT and MRI show that the tumor in the saddle area (inside the red circle) is larger than a ping-pong ball and compresses important nerves and blood vessels around it]

Doing a head CT at the local hospital found that there was a tumor in the head!

On November 8, 2021, Accompanied by her family, Xiaowen went to the Tianxin Pavilion Branch of Hunan Provincial People's Hospital for treatment.

After examining the CT film, Chief Physician Huang Mengyi of the Department of Neurosurgeryngeal Surgery made a preliminary diagnosis of "craniopharyngioma" and admitted her to the ward of the Department of Neurology.

Adolescent girls have menstrual disorders and vision loss, and the culprit is in the brain

【Pituitary stalk under view (Zhang Xiaoquan painting)】

Further examination after admission found that the tumor was about 4.5 × 4.4 ×4 .6cm, larger than a ping-pong ball, surrounded by important nerves and blood vessels such as the internal carotid artery, optic nerve, three ventricle floors, cavernous sinuses, pituitary gland, pituitary stalk, etc.

Doctors told Xiaowen and her family that because the tumor compressed the optic nerve, it caused her vision to lose, and also compressed the pituitary gland, resulting in her endocrine disorders, menstrual disorders, and the formation of cranial hypertension.

If surgery is not performed as soon as possible, the disease may continue to progress and be life-threatening.

Adolescent girls have menstrual disorders and vision loss, and the culprit is in the brain

[Chief Physician Huang Mengyi and Deputy Chief Physician Chen Lei performed microscopic transplate pool approach craniopharyngioma resection surgery for patients]

The preoperative discussion in the surgical group believes that because the tumor is wrapped in the optic nerve, internal carotid artery, oculomotor nerve, pituitary gland, etc., once these important nerves and blood vessels are damaged during the operation, it may lead to irreversible sequelae.

Through three-dimensional reconstruction and surgical exercises, Chief Physician Huang Mengyi and Deputy Chief Physician Chen Lei estimated the difficulties that may be encountered during surgery and formulated corresponding countermeasures.

On November 22, Chief Physician Huang Mengyi and Deputy Chief Physician Chen Lei performed microscopic craniopharyngioma resection for Xiaowen under general anesthesia, and successfully removed this "time bomb".

Adolescent girls have menstrual disorders and vision loss, and the culprit is in the brain

【Postoperative head CT display: the tumor in the saddle area is basically removed (the red circle is the surgical area)】

On the fourth day after the operation, Xiaowen was able to eat normally, and on the sixth day after the operation, she was transferred back to the general ward and was discharged from the hospital on December 13.

Adolescent girls have menstrual disorders and vision loss, and the culprit is in the brain

[Before discharge, Xiaowen and her family praised the provincial medical neurosurgery team]

"Craniopharyngioma is a benign tumor of the central nervous system located in the saddle or parasellar region", said Chief Physician Huang Mengyi, craniopharyngioma is a common non-glial cell tumor in children and adolescents, with a high incidence of 5 to 15 years old, accounting for 54% of intracranial tumors in this age group.

Because the early symptoms of the disease are not obvious, often when the cranial hypertension develops, the cause of the head will be considered and then investigated, at which time irreversible injury usually occurs.

In this regard, Huang Mengyi reminded that if children have repeated headaches, short stature, polyuria, obesity, genital development retardation and other manifestations of hypopituitarism in the process of growth and development, they should undergo a systematic examination to find or exclude craniopharyngioma as soon as possible, so as to achieve early detection, early diagnosis and early treatment.

(Editing Rainbow.) )

Hunan Medical Chat Special Author: Hunan Provincial People's Hospital Liang Hui Zhang Xiaoquan

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