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Pituitary apoplexy
Affiliations- Department of Neurology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland
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Abstract
Pituitary apoplexy (PA) is a clinical syndrome caused by acute haemorrhage and/or infarction of the pituitary gland, generally within a frequently undiagnosed pituitary adenoma. The sudden increase in pituitary gland volume is responsible for typical symptoms: severe headache, nausea, vomiting, visual impairment, cranial nerve palsies, deteriorating level of consciousness, and hypopituitarism. Radiological evidence, especially magnetic resonance imaging (MRI) which is the most sensitive diagnostic modality, establishes the diagnosis. Multiple risk factors have been reported, although the majority of cases have no identifiable precipitants. The management strategy depends on the clinical manifestation, as well as the presence of co-morbidities, and remains controversial. Post apoplexy, there needs to be careful monitoring for recurrence of tumour growth and endocrinological function of the pituitary. This disease is rare but potentially life-threatening without rapid treatment. Because there are no randomised studies, it is suggested that further trials are needed to optimise proper management.
Abstract
Pituitary apoplexy (PA) is a clinical syndrome caused by acute haemorrhage and/or infarction of the pituitary gland, generally within a frequently undiagnosed pituitary adenoma. The sudden increase in pituitary gland volume is responsible for typical symptoms: severe headache, nausea, vomiting, visual impairment, cranial nerve palsies, deteriorating level of consciousness, and hypopituitarism. Radiological evidence, especially magnetic resonance imaging (MRI) which is the most sensitive diagnostic modality, establishes the diagnosis. Multiple risk factors have been reported, although the majority of cases have no identifiable precipitants. The management strategy depends on the clinical manifestation, as well as the presence of co-morbidities, and remains controversial. Post apoplexy, there needs to be careful monitoring for recurrence of tumour growth and endocrinological function of the pituitary. This disease is rare but potentially life-threatening without rapid treatment. Because there are no randomised studies, it is suggested that further trials are needed to optimise proper management.
Keywords
pituitary apoplexy, pituitary adenoma, hypopituitarism, management, outcome
About this articleTitle
Pituitary apoplexy
Journal
Neurologia i Neurochirurgia Polska
Issue
Article type
Review Article
Pages
413-420
Published online
2019-11-20
Page views
2107
Article views/downloads
602
DOI
Pubmed
Bibliographic record
Neurol Neurochir Pol 2019;53(6):413-420.
Keywords
pituitary apoplexy
pituitary adenoma
hypopituitarism
management
outcome
Authors
Małgorzata Wichlińska-Lubińska
Grzegorz Kozera
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