Coma after pituitary surgery

Introduction Patients with pituitary resection after pituitary resection or metastatic breast cancer, severe diabetic retinopathy, etc., may have coma, have pituitary dysfunction before surgery, are more likely to occur, coma after pituitary resection, due to local injury Causes disturbance of consciousness, but also due to decreased function of endocrine glands. In particular, pre-operative adrenal insufficiency, can not tolerate severe irritation caused by surgery, or due to water and electrolyte metabolism disorder before and after surgery, patients can not recover after surgery, showing a state of lethargy or coma, which lasts for several days. For months, incontinence and incontinence, there may still be a reaction to pain. Sometimes it can be temporarily awakened. The holding reflection and the sucking reflex disappear, the pulse rate and blood pressure can be normal or slightly lower, and the body temperature can be high or low, or normal. Blood sugar and blood sodium can also be normal or slightly lower. A type of pituitary crisis, when the function of the anterior pituitary is reduced, the adrenal cortex hormone and thyroid hormone are deficient, the body's stress ability is reduced, in the case of infection, vomiting, diarrhea, dehydration, cold, hunger, etc. or the application of sleeping pills and anesthetics Inducing a crisis.

Cause

Pituitary dysfunction before surgery, prone to occur, coma after pituitary resection, may cause disturbance of consciousness due to local injury, but also due to endocrine gland dysfunction, especially preoperative adrenal insufficiency, can not tolerate surgery Caused by severe irritation, or due to water and electrolyte metabolism disorders before and after surgery.

an examination

Postoperative unconsciousness, drowsiness, coma, can last for several days to several weeks, pulse rate and low, body temperature can be low or high, normal, blood sodium, blood sugar is normal or low.

Differential diagnosis

(1) Low blood sugar coma, the most common. Often occurs on an empty stomach, palpitations, sweating, dizziness, disturbance of consciousness, sometimes mental disorders and convulsions or epileptic seizures, and finally coma.

(2) Infectious coma, low resistance, prone to infection, may be associated with high fever; and unconsciousness and coma.

(3) Low body temperature coma, more common in the cold winter and when the patient is not warm.

(4) Toxic coma in water, due to lack of corticosteroids, the ability to regulate water metabolism is reduced. When too much infusion and drinking water, it is prone to toxic coma in water. Water poisoning is nausea, vomiting, collapse, insanity, convulsions and coma.

(5) coma after pituitary resection, postoperative unconsciousness, drowsiness, coma, lasting for several days to several weeks, pulse rate and low, body temperature can be low or high, normal blood sodium, blood sugar or partial low.

(6) Pituitary apoplexy due to acute bleeding in pituitary tumors. Rapid onset, headache, dizziness, vomiting, decreased vision, blindness, even shock, coma.

(7) Sedation and coma caused by narcotics. Patients with this disease are very sensitive to sedatives and anesthetics. Sometimes, regular doses can cause drowsiness or coma. And the duration is extended.

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