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Post-traumatic pituitary apoplexy--two case reports.

H Uchiyama¹, S Nishizawa, A Satoh

¹Department of Neurosurgery, Hamamatsu Red Cross Hospital, Shizuoka.

Neurologia Medico-Chirurgica

|March 27, 1999

Summary

This summary is machine-generated.

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Head trauma can cause pituitary apoplexy in patients with asymptomatic pituitary macroadenoma, leading to sudden vision loss. Emergency surgery, particularly transsphenoidal surgery, can restore vision by decompressing the optic nerves.

Area of Science:

Neuroscience
Endocrinology
Neurosurgery

Background:

Pituitary apoplexy is a rare but serious complication of pituitary macroadenomas.
Traumatic brain injury can precipitate pituitary apoplexy, even in cases of asymptomatic tumors.

Observation:

Two patients presented with severe visual disturbances following head trauma, linked to pituitary macroadenomas with intratumoral hemorrhage.
Imaging revealed dumbbell-shaped suprasellar extensions and hemorrhage within the pituitary tumors.

Findings:

The proposed mechanism involves shearing forces on the tumor due to rotational head trauma, leading to apoplexy.
Surgical decompression of the optic nerves, especially via transsphenoidal surgery, resulted in visual recovery in both patients.

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Implications:

Prompt surgical intervention is crucial for visual recovery in post-traumatic pituitary apoplexy.
Transsphenoidal surgery is highlighted as an effective and advantageous approach for acute optic nerve decompression.
Staged surgery may be necessary for complete tumor removal after the acute phase.