Pituitary apoplexy: pathophysiology, diagnosis and management
Pituitary apoplexy is characterized by sudden increase in pituitary gland volume secondary to ischemia and/or necrosis, usually in a pituitary adenoma. Most cases occur during the 5th decade of life, predominantly in males and in previously unknown clinically non-functioning pituitary adenomas. Ther...
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| Format: | Article |
| Language: | English |
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Brazilian Society of Endocrinology and Metabolism
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| Series: | Archives of Endocrinology and Metabolism |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2359-39972015000300259&lng=en&tlng=en |
| _version_ | 1828372174817198080 |
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| author | Andrea Glezer Marcello D. Bronstein |
| author_facet | Andrea Glezer Marcello D. Bronstein |
| author_sort | Andrea Glezer |
| collection | DOAJ |
| description | Pituitary apoplexy is characterized by sudden increase in pituitary gland volume secondary to ischemia and/or necrosis, usually in a pituitary adenoma. Most cases occur during the 5th decade of life, predominantly in males and in previously unknown clinically non-functioning pituitary adenomas. There are some predisposing factors as arterial hypertension, anticoagulant therapy and major surgery. Clinical picture comprises headache, visual impairment, cranial nerve palsies and hypopituitarism. Most cases improve with both surgical and expectant management and the best approach in the acute phase is still controversial. Surgery, usually by transsphenoidal route, is indicated if consciousness and/or vision are impaired, despite glucocorticoid replacement and electrolyte support. Pituitary function is impaired in most patients before apoplexy and ACTH deficiency is common, which makes glucocorticoid replacement needed in most cases. Pituitary deficiencies, once established, usually do not recover, regardless the treatment. Sellar imaging and endocrinological function must be periodic reevaluated. Arch Endocrinol Metab. 2015;59(3):259-64 |
| first_indexed | 2024-04-14T07:00:40Z |
| format | Article |
| id | doaj.art-d328e18fa6774f1e86ebcb13ad6cff41 |
| institution | Directory Open Access Journal |
| issn | 2359-4292 |
| language | English |
| last_indexed | 2024-04-14T07:00:40Z |
| publisher | Brazilian Society of Endocrinology and Metabolism |
| record_format | Article |
| series | Archives of Endocrinology and Metabolism |
| spelling | doaj.art-d328e18fa6774f1e86ebcb13ad6cff412022-12-22T02:06:47ZengBrazilian Society of Endocrinology and MetabolismArchives of Endocrinology and Metabolism2359-429259325926410.1590/2359-3997000000047S2359-39972015000300259Pituitary apoplexy: pathophysiology, diagnosis and managementAndrea GlezerMarcello D. BronsteinPituitary apoplexy is characterized by sudden increase in pituitary gland volume secondary to ischemia and/or necrosis, usually in a pituitary adenoma. Most cases occur during the 5th decade of life, predominantly in males and in previously unknown clinically non-functioning pituitary adenomas. There are some predisposing factors as arterial hypertension, anticoagulant therapy and major surgery. Clinical picture comprises headache, visual impairment, cranial nerve palsies and hypopituitarism. Most cases improve with both surgical and expectant management and the best approach in the acute phase is still controversial. Surgery, usually by transsphenoidal route, is indicated if consciousness and/or vision are impaired, despite glucocorticoid replacement and electrolyte support. Pituitary function is impaired in most patients before apoplexy and ACTH deficiency is common, which makes glucocorticoid replacement needed in most cases. Pituitary deficiencies, once established, usually do not recover, regardless the treatment. Sellar imaging and endocrinological function must be periodic reevaluated. Arch Endocrinol Metab. 2015;59(3):259-64http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2359-39972015000300259&lng=en&tlng=enPituitaryapoplexypituitary adenomahypopituitarism |
| spellingShingle | Andrea Glezer Marcello D. Bronstein Pituitary apoplexy: pathophysiology, diagnosis and management Archives of Endocrinology and Metabolism Pituitary apoplexy pituitary adenoma hypopituitarism |
| title | Pituitary apoplexy: pathophysiology, diagnosis and management |
| title_full | Pituitary apoplexy: pathophysiology, diagnosis and management |
| title_fullStr | Pituitary apoplexy: pathophysiology, diagnosis and management |
| title_full_unstemmed | Pituitary apoplexy: pathophysiology, diagnosis and management |
| title_short | Pituitary apoplexy: pathophysiology, diagnosis and management |
| title_sort | pituitary apoplexy pathophysiology diagnosis and management |
| topic | Pituitary apoplexy pituitary adenoma hypopituitarism |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2359-39972015000300259&lng=en&tlng=en |
| work_keys_str_mv | AT andreaglezer pituitaryapoplexypathophysiologydiagnosisandmanagement AT marcellodbronstein pituitaryapoplexypathophysiologydiagnosisandmanagement |