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Pituitary apoplexy associated with cardiac surgery
American Journal of Ophthalmology
|September 15, 1984
Summary
Pituitary apoplexy, a rare complication, occurred post-cardiac surgery in two patients with undiagnosed pituitary adenomas. Hemodynamic instability and anticoagulation were likely triggers for this serious condition.
Area of Science:
- Neurosurgery
- Cardiology
- Endocrinology
Background:
- Pituitary apoplexy is a rare but serious complication.
- Cardiac surgery with extracorporeal bypass carries inherent risks.
- Undiagnosed pituitary adenomas can remain asymptomatic until a stressful event.
Observation:
- Two patients developed pituitary apoplexy in the immediate postoperative period after cardiac surgery.
- Both patients had pre-existing, asymptomatic pituitary adenomas.
- Clinical presentations included ophthalmoplegia, visual loss, and hemiparesis.
Findings:
- Pathological confirmation of pituitary apoplexy in both cases.
- Hemodynamic instability during and after cardiac surgery as a probable precipitating factor.
- Anticoagulation therapy as another potential contributing factor.
Implications:
- Highlights the importance of considering pituitary apoplexy in postoperative patients with neurological deficits.
- Suggests potential screening for pituitary adenomas in patients undergoing major surgery.
- Emphasizes careful hemodynamic management and anticoagulation protocols in cardiac surgery patients.