P.144 Artery of Percheron Infarction following endoscopic transsphenoidal surgery: a case series and literature review
Bibliographic record
Abstract
Background: Artery of Percheron (AOP) infarct is a rare but devastating complication following endoscopic transnasal transsphenoidal surgery (ETTS) for pituitary adenoma resection, characterized by decreased level of consciousness, mydriasis, and cognitive impairment. We reported two new and one remote case in a single institution. Methods: A retrospective case analysis and literature review was conducted. All patients had MRI-confirmed bilateral paramedian thalamic and/or midbrain infarcts following primary or redo ETTS for pituitary adenomas. Results: 8 total cases were identified, with a mean age of 45.8 years (SD: 6.06), including 6 females (75%) and 2 males (25%), undergoing initial (6/8, 75%) or repeat (2/8, 25%) ETTS for pituitary macroadenomas. Tumour consistency was solid in 6/8 (75%), hemorrhagic in 1/8 (12.5%) and cystic in 1/8 (12.5%). MRI showed bilateral paramedian thalamic infarcts (8/8 100%), with midbrain extension in 5/8 (62.5%). Intraoperative CSF leaks occurred in 6 of 8 (75%). The mean Glasgow Outcome Scale (GOS) score was 3 (range 2-4, SD: 0.37) at a mean follow-up of 8.6 (SD: 5.5) months. Conclusions: AOP infarcts are rare following ETTS for pituitary adenomas. Possible associations include large tumour size, firm consistency, and intraoperative CSF leak. Clinical outcomes are typically poor and characterized by severe long-term disability.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.007 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".