For patients with pituitary tumor who still have headache with vision loss after surgery, there are mainly the following reasons: bleeding in the operation area: this is also the most common reason, the hematoma in the operation area generates local compression symptoms, at this time, we need to conduct cranial CT examination as soon as possible to clarify and guide the next treatment according to the results.
Residual tumor stroke: Especially in transsphenoidal surgery where a part of the tumor is removed, the residual tumor undergoes ischemic necrosis and the volume occurs to increase significantly, causing headache with visual impairment, even worse than the preoperative symptoms.
Acute intracranial hypertension: Intraoperative bleeding into the subarachnoid space and postoperative reactive intracranial pressure increase are often the triggers.
Cerebral vasospasm: Cerebral vasospasm can cause intracranial ischemia and increased intracranial pressure causing headache; intraoperative operation harassment of cerebral vessels can cause local or whole cerebral vasospasm, especially optic nerve vasospasm can produce symptoms of vision loss.