1. [Pituitary apoplexy: an endocrinologic emergency].
- Author
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Noordzij MJ, de Heide LJ, van den Berg G, and Hoving EW
- Subjects
- Adenoma complications, Adenoma therapy, Adult, Aged, Emergencies, Female, Headache etiology, Humans, Male, Nausea etiology, Pituitary Apoplexy etiology, Pituitary Apoplexy therapy, Pituitary Hormones blood, Pituitary Neoplasms complications, Pituitary Neoplasms therapy, Pregnancy, Pregnancy Complications, Cardiovascular etiology, Pregnancy Complications, Cardiovascular therapy, Treatment Outcome, Visual Acuity, Adenoma diagnosis, Pituitary Apoplexy diagnosis, Pituitary Neoplasms diagnosis, Pregnancy Complications, Cardiovascular diagnosis
- Abstract
A 32-year-old woman, a 73-year-old man and a 26-year-old pregnant woman presented with headache, vomiting, and variable presence of visual disturbances, impaired consciousness, and circulatory shock. All three had pituitary apoplexy. In the first patient lymphocytic hypophysitis was diagnosed, the second had a nonfunctional adenoma and the last patient probably also. All three patients were treated conservatively with full recovery of signs and symptoms. However pituitary insufficiency remained in all three. Pituitary apoplexy is an acute event with significant morbidity and mortality. The cause is a rapid expansion of, usually, a pre-existing, often not yet known, adenoma by massive haemorrhage or infarction. Pressure, among other things, causes hypopituitarism, meningism, compression of the chiasma opticum and visual disturbances. Although many predisposing factors have been identified, pituitary apoplexy is often an unpredictable event. Diagnosis is made by the typical clinical presentation, eye examination, MRI and by measuring pituitary hormones. Treatment is with suppletion of the deficient hormones and in selected patients by transsphenoidal decompression surgery.
- Published
- 2005