Bromocriptine-induced cerebrospinal fluid fistula in patients with macroprolactinomas: report of three cases and a review of the literature

Surg Neurol. 1994 Jun;41(6):486-9. doi: 10.1016/0090-3019(94)90013-2.

Abstract

Bromocriptine therapy for macroprolactinoma induced cerebrospinal fluid (CSF) rhinorrhea in three patients. The tumor had extended well beyond the sella turcica and caused bony erosion in all the cases. All three patients responded to bromocriptine therapy rapidly. CSF fistula occurred concomitantly with the reduction of tumor size and caused meningitis in two of the patients. Withdrawal of bromocriptine resulted in cessation of the leakage. One of the patients underwent transsphenoidal repair. Two patients refused surgery. This potentially lethal complication encountered in these three cases demonstrates the need for close supervision of macroprolactinoma patients with skull base erosion placed under bromocriptine therapy.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Bromocriptine / adverse effects*
  • Cerebrospinal Fluid Rhinorrhea / chemically induced*
  • Female
  • Fistula / chemically induced*
  • Humans
  • Male
  • Middle Aged
  • Pituitary Neoplasms / complications
  • Pituitary Neoplasms / diagnostic imaging
  • Pituitary Neoplasms / drug therapy*
  • Prolactinoma / complications
  • Prolactinoma / diagnostic imaging
  • Prolactinoma / drug therapy*
  • Tomography, X-Ray Computed

Substances

  • Bromocriptine