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KMID : 1036520120020010043
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Clinical Neuro-Ophthalmology
2012 Volume.2 No. 1 p.43 ~ p.46
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Pituitary Apoplexy
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Lee Tae-Kyeong
Choi Jae-Hwan
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Abstract
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Pituitary apoplexy refers to a rare clinical syndrome by the rapid expansion of the contents in the pituitary fossa that may result in sudden onset headache, visual loss, ophthalmoplegia, hypopituitarism, and consciousness disturbance. This usually results from hemorrhage, infarction, or hemorrhagic infarction of a preexisting adenoma. The pathophysiology has been postulated due to the unique vasculature that may be distorted or compressed by rapidly growing mass. Less than 50% of pituitary apoplexy has precipitating or association factors that might result in ischemic or hemorrhagic insult to the pituitary gland including major operation, pituitary stimulating hormone tests, postpartum, etc. Management of the pituitary apoplexy should begin with high-dose glucocorticoids and supportive therapy maintaining fluid-electrolyte balance. The main object of the therapy is saving life and the vision. Transsphenoidal surgery is the mainstay of the therapy. However, in some instances the medical therapy with glucocorticoids can be sufficient to save the vision and remain minimal residua. Whether surgery should be done at emergency or delay has been debated to save the vision and it depends on the clinical course whether it could result in visual loss or threaten life.
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KEYWORD
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Pituitary apoplexy, Visual loss, Pituitary adenoma
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