{"id":"48f3c015-f657-4909-9356-87b5f092f1cb","slug":"pituitary-macroadenoma-apoplexy-in-a-severe-acute-respiratory-syndrome-coronavirus-2-positive-testing-causal-or-casual","title":"Pituitary macroadenoma apoplexy in a severe acute respiratory syndrome-coronavirus-2-positive testing: Causal or casual?","authors":["Saúl Solorio-Pineda","César Adán Almendárez-Sánchez","Abrahan Alfonso Tafur-Grandett","Gabriel Arturo Ramos-Martínez","Raúl Huato-Reyes","Milton Inocencio Ruiz-Flores","Antonio Sosa-Najera"],"abstract":"Background: In December 2019, in Wuhan, a new virus emerged, causing severe acute respiratory syndrome (SARS) secondary to infection by a type of coronavirus, causing coronavirus disease (COVID-19). The pandemic caused by the new coronavirus has had implications in the central nervous system. COVID-19 is known to be characterized by coagulation activation and endothelial dysfunction, causing ischemic and hemorrhagic vascular syndromes. Case Description: A 27-year-old male patient case with progressive decrease in visual acuity, associated with respiratory symptoms and intense headache. Multilobar infiltrate with a reticulonodular pattern is evident on chest CT scan. Brain CT scan with pituitary macroadenoma apoplexy was shown. SARS-Cov2 was confirmed, and respiratory support initiated. However, the patient died shortly afterward, secondary to pulmonary complications. Conclusion: The angiotensin-converting enzyme (ACE) II receptor is expressed in circumventricular organs and in cerebrovascular endothelial cells, which play a role in vascular autoregulation and cerebral blood flow. For this reason, is rational the hypothesize that brain ACE II could be involved in COVID-19 infection. Underlying mechanisms require further elucidation in the future.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/48f3c015-f657-4909-9356-87b5f092f1cb/featured/hero-1781563118501.png","publishDate":"2020-09-25T00:00:00.000Z","doi":"10.25259/SNI_305_2020","categories":["Neuro-oncology","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2020/09/10289/SNI-11-304.pdf"}