pituitary apoplexy

Clicks: 218
ID: 191075
2011
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Abstract
Pituitary apoplexy is rare endocrine emergency which can occur due to infarction or haemorrhage of pituitary gland. This disorder most often involves a pituitary adenoma. Occasionally it may be the first manifestation of an underlying adenoma. There is conflicting data regarding which type of pituitary adenoma is prone for apoplexy. Some studies showed predominance of non-functional adenomas while some other studies showed a higher prevalence in functioning adenomas amongst which prolactinoma have the highest risk. Although pituitary apoplexy can occur without any precipitating factor in most cases, there are some well recognizable risk factors such as hypertension, medications, major surgeries, coagulopathies either primary or following medications or infection, head injury, radiation or dynamic testing of the pituitary. Patients usually present with headache, vomiting, altered sensorium, visual defect and/or endocrine dysfunction. Hemodynamic instability may be result from adrenocorticotrophic hormone deficiency. Imaging with either CT scan or MRI should be performed in suspected cases. Intravenous fluid and hydrocortisone should be administered after collection of sample for baseline hormonal evaluation. Earlier studies used to advocate urgent decompression of the lesion but more recent studies favor conservative approach for most cases with surgery reserved for those with deteriorating level of consciousness or increasing visual defect. The visual and endocrine outcomes are almost similar with either surgery or conservative management. Once the acute phase is over, patient should be re-evaluated for hormonal deficiencies.
Reference Key
ranabir2011indianpituitary Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors ;Salam Ranabir;Manash P Baruah
Journal journal of physical chemistry a
Year 2011
DOI
10.4103/2230-8210.84862
URL
http://www.ijem.in/article.asp?issn=2230-8210;year=2011;volume=15;issue=7;spage=188;epage=196;aulast=Ranabir
Keywords
hypopituitarism Gastroenterology clinical endocrinologydiseases of the digestive system

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