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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
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Published on: January 17, 2018

Pituitary apoplexy.

Salam Ranabir1, Manash P Baruah

  • 1Department of Medicine, Regional Institute of Medical Sciences, Imphal, Manipur, India.

Indian Journal of Endocrinology and Metabolism
|October 27, 2011
PubMed
Summary
This summary is machine-generated.

Pituitary apoplexy, a rare endocrine emergency, often involves pituitary adenomas. Management strategies are evolving, with a conservative approach favored for most cases, reserving surgery for severe symptoms.

Keywords:
Apoplexyhypopituitarismpituitary

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Area of Science:

  • Endocrinology
  • Neurology
  • Neurosurgery

Background:

  • Pituitary apoplexy is a rare endocrine emergency resulting from pituitary gland infarction or hemorrhage.
  • It most commonly involves a pituitary adenoma and can be its initial presentation.
  • Risk factors include hypertension, medications, surgery, coagulopathies, head injury, and radiation.

Purpose of the Study:

  • To review the current understanding of pituitary apoplexy.
  • To discuss its presentation, risk factors, and diagnostic approaches.
  • To evaluate current management strategies and outcomes.

Main Methods:

  • Review of existing literature on pituitary apoplexy.
  • Analysis of clinical presentation, risk factors, and diagnostic imaging (CT/MRI).
  • Evaluation of treatment outcomes for conservative versus surgical management.

Main Results:

  • Patients typically present with headache, vomiting, altered sensorium, visual defects, and endocrine dysfunction.
  • Hemodynamic instability can occur due to adrenocorticotrophic hormone deficiency.
  • Recent evidence favors a conservative management approach, with surgery reserved for specific indications.

Conclusions:

  • Pituitary apoplexy requires prompt diagnosis and management, including hormonal evaluation and fluid/steroid administration.
  • Visual and endocrine outcomes are comparable between surgical and conservative treatments.
  • Long-term re-evaluation for hormonal deficiencies is essential after the acute phase.