scholarly journals Agyalapimirigy-apoplexia.

2021 ◽  
Vol 162 (38) ◽  
pp. 1520-1525
Author(s):  
László Sipos ◽  
Nikolette Szücs ◽  
Péter Várallyay
Keyword(s):  
Pituitary Adenoma ◽  
Retrospective Studies ◽  
Pituitary Apoplexy ◽  
Sudden Onset ◽  
Clinical Syndrome ◽  
Resonance Imaging ◽  
Altered Consciousness ◽  
Wait And See ◽  
Neurosurgical Intervention ◽  
Visual Disturbances

Összefoglaló. Az agyalapimirigy-apoplexia ritka klinikai kórkép, mely hirtelen kialakult bevérzés vagy infarktus következményeként jelenik meg. A hypophysisadenomás betegek 2–12%-ában fordul elő, a leggyakrabban funkcionálisan inaktív daganatokban, de jelentkezhet gyógyszeresen kezelt adenomákban is. Klinikai képe hirtelen kialakuló heves fejfájás, mely látászavarral vagy kettős látással társulhat, de meningealis izgalmi jel, a tudati szint romlása is előfordulhat. A bevérzés miatt kialakult kortikotropinhiány kezelés nélkül mellékvese-elégtelenséghez vezet. A mágneses rezonancia a komputertomográfhoz képest jobban kimutatja az adenoma bevérzését vagy akár infarktusát. Retrospektív tanulmányok a korábbi, azonnali idegsebészeti beavatkozás helyett a konzervatív kezelés létjogosultságát emelik ki. Orv Hetil. 2021; 162(38): 1520–1525. Summary. Pituitary apoplexy is a rare clinical syndrome secondary to haemorrhage or infarction of pituitary adenoma. The prevalence is 2–12% of pituitary adenoma patients especially in nonfunctioning tumours but may be found in medically treated adenomas as well. Its clinical picture is sudden onset of headache with visual disturbances and/or ocular palsy. Meningeal signs and altered consciousness can occur. Corticotropin deficiency if untreated can lead to adrenal insufficiency. Compared to computed tomography, magnetic resonance imaging better demonstrates the haemorrhage or even infarction of pituitary adenoma. Retrospective studies emphasize the wait-and-see management instead of the formerly considered urgent neurosurgical intervention. Orv Hetil. 2021; 162(38): 1520–1525.

scholarly journals Pituitary apoplexy following endoscopic nasal surgery: A case report

2019 ◽  
Vol 7 ◽  
pp. 2050313X1985586
Author(s):  
Teemu Harju ◽  
Juha Alanko ◽  
Jura Numminen
Keyword(s):  
Pituitary Adenoma ◽  
Pituitary Apoplexy ◽  
Sudden Onset ◽  
Pituitary Macroadenoma ◽  
Nasal Surgery ◽  
Resonance Imaging ◽  
Acute Haemorrhage ◽  
Endoscopic Nasal Surgery ◽  
Precipitating Factor ◽  
Field Defects

Pituitary apoplexy develops as a consequence of acute haemorrhage and/or infarction in a pre-existing pituitary adenoma. Typical symptoms include sudden onset headache, visual acuity/field defects, and ocular palsies. We report a male patient with a known pituitary macroadenoma who underwent a right-sided endoscopic nasal surgery. Preoperatively, thickening of sphenoid mucosa was seen in computed tomography and magnetic resonance imaging. The patient developed pituitary apoplexy postoperatively. The presented report indicates that in patients with a pituitary adenoma, nasal surgery – like any other kind of surgery – is a possible precipitating factor for pituitary apoplexy. Isolated thickening of sphenoid mucosa is associated with pituitary apoplexy. It may also precede an apoplectic event.

Acute stroke in pituitary adenomas complicated by pituitary apoplexy

2016 ◽  
Vol 21 (3) ◽  
pp. 136-139
Author(s):  
Miralim M. Azizov
Keyword(s):  
Pituitary Adenoma ◽  
Pituitary Apoplexy ◽  
Clinical Signs ◽  
Pituitary Tumors ◽  
Clinical Syndrome ◽  
Left Internal Carotid Artery ◽  
Left Middle Cerebral Artery ◽  
Ischemic Brain ◽  
Left Middle ◽  
Visual Disturbances

Pituitary apoplexy is a clinical syndrome that is manifested by headache, visual disturbances, ophthalmoplegia or impaired consciousness. It can develop as a result of necrosis or hemorrhage in the pituitary gland or in cases of pituitary tumors. A favorable prognosis is possible if early diagnosis and timely surgical treatment. Pituitary apoplexy complicated by the disorder of the cerebral circulation occurs relatively rare. We observed the female patient aged of 51 year with pituitary adenoma, clinical signs of which were sudden depression of consciousness, right hemiparesis and left-sided ptosis. Signs of pituitary apoplexy were revealed after performed examinations. The sharp increase in the size of the tumor resulted in a compression of supraclinoid portion of the left internal carotid artery, which was the cause of ischemic brain damage in the pool left middle cerebral artery. After 2 weeks of conservative treatment, the patient was undergone to the surgery via transsphenoidal access. Histological examination confirmed the hemorrhage and necrosis of the pituitary adenoma. Complication developed 3 months after surgery partially regressed. Taking into account the relatively rare occurrence of pituitary apoplexy complicated with cerebrovascular ischemic type, clinicians should be alert to this complication. The method of choice is transsphenoidal delayed adenomectomy with conservative therapy.

scholarly journals Successful Pregnancy in a Female with a Large Prolactinoma after Pituitary Tumor Apoplexy

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Butheinah A. Al-Sharafi ◽  
Omar H. Nassar
Keyword(s):  
Magnetic Resonance Imaging ◽  
Pituitary Adenoma ◽  
Magnetic Resonance ◽  
Pituitary Apoplexy ◽  
Rare Condition ◽  
Empty Sella ◽  
Resonance Imaging ◽  
Successful Pregnancy ◽  
Empty Sella Syndrome ◽  
History Of

Pituitary apoplexy is a rare condition which may cause death of the patient in severe cases and many times leads to hypopituitarism. We report a case of apoplexy in a large prolactinoma resulting in empty sella syndrome followed by a successful pregnancy. Our patient is a 32-year-old female with a history of a macroprolactinoma for approximately 17 years who presented to our hospital with a history of severe headache, decreased level of consciousness, fever, nausea, vomiting, and diplopia of 12 hours duration. Magnetic resonance imaging done on admission showed an increase in the size of the pituitary adenoma with a subtle hemorrhage. The patient was admitted to the intensive care unit and treated conservatively. The condition of the patient improved within a few days. A few months later, she started having regular menstrual periods. A magnetic resonance imaging of the pituitary 1.5 years later was reported as empty sella syndrome, and approximately one year later she became pregnant. With the pituitary adenoma being resolved after developing pituitary apoplexy and continuing on cabergoline, the patient had a successful pregnancy with no recurrence of the adenoma after delivery and breastfeeding.

scholarly journals Recurrent pituitary apoplexy in pregnancy

2021 ◽  
Vol 14 (8) ◽  
pp. e242353
Author(s):  
Franziska Geissler ◽  
Irene Hoesli ◽  
Monya Todesco Bernasconi
Keyword(s):  
Pituitary Adenoma ◽  
Pituitary Gland ◽  
Preterm Delivery ◽  
Pituitary Apoplexy ◽  
Signs And Symptoms ◽  
Visual Disturbance ◽  
Severe Headache ◽  
Altered Consciousness ◽  
Existing Data ◽  
In Pregnancy

Pituitary apoplexy is caused by haemorrhage or infarction of the pituitary gland. Presenting signs and symptoms often include severe headache, visual disturbance, ophthalmoplegia, altered consciousness and impaired pituitary function. The management of pituitary apoplexy has very rarely been described during pregnancy and there is no existing data for further pregnancies of affected women. We present a case of a woman with a recurrent pituitary apoplexy due to haemorrhages in a pituitary adenoma in her third and fourth pregnancies. In both pregnancies, the pituitary apoplexy was managed conservatively, but due to therapy-resistant headaches, a preterm delivery was implemented.

scholarly journals Pituitary Apoplexy, Meningitis and Cerebral Infarction - A Perplexing Trifecta

2021 ◽  
Author(s):  
Thirumalai V. Srivatsan ◽  
Haroon M. Pillay ◽  
Lakshay Raheja
Keyword(s):  
Cerebral Infarction ◽  
Visual Loss ◽  
Pituitary Apoplexy ◽  
Sudden Onset ◽  
Neurological Deficits ◽  
Rapid Progression ◽  
Altered Consciousness ◽  
Cerebral Infarcts ◽  
Endocrine Disturbances ◽  
Rare Manifestation

AbstractPituitary apoplexy (PA) is a clinical diagnosis comprising a sudden onset of headache, neurological deficits, endocrine disturbances, altered consciousness, visual loss, or ophthalmoplegia. However, clinically, the presentation of PA is extremely variable and occasionally fatal. While meningitis and cerebral infarcts are themselves serious diseases, they are rarely seen as manifestations of PA and are exceedingly rare when present together.We present the case of a 20-year-old male with a rapid progression of symptoms of meningitis, PA and stroke. The present article seeks to emphasize a rare manifestation of PA with an attempt to understand the intricacies of its evaluation and management.

scholarly journals Pituitary Adenoma with Apoplexy with Arteriovenous Malformation

2017 ◽  
Vol 06 (01) ◽  
pp. 059-061
Author(s):  
Rajeev Bansal ◽  
Jitendra Shekhawat ◽  
Devendra Purohit
Keyword(s):  
Pituitary Adenoma ◽  
Arteriovenous Malformation ◽  
Pituitary Apoplexy ◽  
Single Case ◽  
Mass Effect ◽  
Sudden Onset ◽  
Sudden Loss ◽  
Rare Association ◽  
Chief Complaints

Background This is a rare association of pituitary adenoma with apoplexy with arteriovenous malformation as only single case was reported prior to this case as per our knowledge. Case Description A 25-year-old man presented with chief complaints of headache of sudden onset, severe in intensity with sudden loss of vision. Imaging shows pituitary adenoma with apoplexy with right parietal arteriovenous malformation. The patient was managed with embolization for parietal arteriovenous malformation and medically for pituitary adenoma with apoplexy. Conclusion Pituitary apoplexy can be treated conservatively if no features of mass effect present. Follow-up of the patient must be done regularly to look for the size of pituitary adenoma and recurrence of arteriovenous malformation.

Presenting Symptoms of Pituitary Apoplexy

2017 ◽  
Vol 79 (01) ◽  
pp. 052-059 ◽  
Author(s):  
Ioannis Mavridis ◽  
Maria Meliou ◽  
Efstratios-Stylianos Pyrgelis
Keyword(s):  
Pituitary Apoplexy ◽  
Sella Turcica ◽  
Abrupt Onset ◽  
Sudden Onset ◽  
Clinical Syndrome ◽  
Medical Emergency ◽  
Sudden Expansion ◽  
Visual Field Defects ◽  
Imaging Method ◽  
Presenting Symptoms

AbstractThe classical term “pituitary apoplexy” (PA) describes a clinical syndrome usually characterized by abrupt onset of headache accompanied by neurologic and/or endocrinologic deterioration due to sudden expansion of a mass within the sella turcica as a result of hemorrhage or infarction within a pituitary tumor and adjacent pituitary gland. PA is a medical emergency and a difficult diagnosis to establish. Thus this article reviews the presenting symptoms of PA patients to help clinicians recognize or at least suspect this critical condition early on. PA commonly occurs in the setting of a preexisting adenoma, and several patients are unaware of its existence prior to the onset of apoplexy symptoms, which are mainly of a neurologic, ophthalmologic, and endocrinologic nature. Neurologic symptoms include sudden-onset severe headache and other symptoms of subarachnoid hemorrhage, symptoms from compression of the cavernous sinus contents, nausea/vomiting, impaired consciousness, and symptoms of meningeal irritation. Ophthalmologic symptoms include visual field defects, visual loss, diplopia, and ophthalmoplegia. Endocrinologic disturbances include pituitary adenoma symptoms, cortisol deficiency, panhypopituitarism, diabetes insipidus, and syndrome of inappropriate secretion of antidiuretic hormone. Magnetic resonance imaging is the imaging method of choice to aid the PA diagnosis. Its differential diagnoses include cerebrovascular accidents, infectious diseases, and other causes of endocrinologic imbalance. Transsphenoidal surgery is the treatment of choice, especially if there are associated visual abnormalities and ophthalmoplegia. Clinicians should be aware of the presenting symptoms because early diagnosis may reduce the morbidity and mortality of this neurosurgical emergency.

Clinical versus Subclinical Pituitary Apoplexy: Presentation, Surgical Management, and Outcome in 21 Patients

Neurosurgery ◽  
1990 ◽  
Vol 26 (6) ◽  
pp. 980-986 ◽  
Author(s):  
Stephen T. Onesti ◽  
Thomas Wisniewski ◽  
Kalmon D. Post
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Pituitary Apoplexy ◽  
Clinical Signs ◽  
Sudden Onset ◽  
Resonance Imaging ◽  
Duration Of Symptoms ◽  
Computed Tomographic ◽  
Sellar Tumor

Abstract A retrospective review of 16 consecutive patients with pituitary apoplexy treated over a 10-year period is reported. Eight men and 8 women (mean age, 48 years) underwent transsphenoidal decompression after an average duration of symptoms of 19 days. The diagnosis of pituitary apoplexy was made by the sudden onset of headache (88%), nausea (56%), or meningismus (13%), with or without visual disturbances (75%), in the setting of a sellar tumor on computed tomographic or magnetic resonance imaging scans. Thirteen of 16 patients showed significant improvement of symptoms after surgery (average follow-up, 2.5 years). In addition, 5 patients with clinically silent yet extensive pituitary hemorrhage were treated. Although extensive pituitary hemorrhage often produced fulminant apoplexy, it also presented insidiously over many days with few, if any, clinical signs. Rapid diagnosis, endocrine replacement, and transsphenoidal decompression constituted effective therapy. Magnetic resonance imaging (after at least 12 hours of symptoms) was superior to computed tomography in detecting hemorrhage.

scholarly journals Pituitary apoplexy accompanying temporal lobe epilepsy as a complication: case report

2019 ◽  
Author(s):  
Katsunori Shijo ◽  
Sodai Yoshimura ◽  
Fumi Mori ◽  
Shun Yamamuro ◽  
Koichiro Sumi ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Pituitary Apoplexy ◽  
Rare Complication ◽  
Cranial Nerves ◽  
Clinical Manifestations ◽  
Clinical Syndrome ◽  
Healthy Male ◽  
Case Presentation

Abstract Background : Pituitary apoplexy is an acute clinical syndrome caused by infarction and/or hemorrhage of pituitary adenoma, which typically presents with severe headache, visual deterioration, and endocrine abnormalities. However, temporal lobe epileptic seizure has not been viewed as a symptom of pituitary apoplexy in the literature. Case presentation : To elucidate further such a rare complication of temporal lobe epilepsy-like seizure, we describe here the rare clinical manifestations of a 55-year-old previously healthy male with pituitary apoplexy harboring headache, combined palsies involving cranial nerves III to VI, endocrinologic disturbances, and temporal lobe epilepsy-like seizure. In addition, we discuss the temporal lobe epilepsy associated with pituitary adenoma based on the literature. Conclusion : Although further accumulation of clinical data is needed, we would like to emphasize the importance of recognition of temporal lobe epilepsy-like seizure due to pituitary apoplexy, and to suggest that early surgery should be considered as an option in patients displaying such a rare complication.

scholarly journals Postpartum pituitary apoplexy with isolated oculomotor nerve palsy: A rare medical emergency

2015 ◽  
Vol 06 (04) ◽  
pp. 598-600
Author(s):  
Sujeet Raina ◽  
Vaneet Jearth ◽  
Ashish Sharma ◽  
Rajesh Sharma ◽  
Kewal Mistry
Keyword(s):  
Nerve Palsy ◽  
Pituitary Apoplexy ◽  
Sella Turcica ◽  
Altered Mental Status ◽  
Sudden Onset ◽  
Clinical Syndrome ◽  
Medical Emergency ◽  
Oculomotor Nerve Palsy ◽  
Hormonal Dysfunction ◽  
Third Cranial Nerve Palsy

ABSTRACTPituitary apoplexy is a clinical syndrome characterized by sudden onset headache, visual deficits, ophthalmoplegia, altered mental status, and hormonal dysfunction due to an expanding mass within the sella turcica resulting from hemorrhage or infarction of pituitary gland. We report a case of pituitary apoplexy that developed in postpartum period following postpartum hemorrhage and presented with isolated third cranial nerve palsy.

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