Acta Neurochirurgica

, Volume 152, Issue 5, pp 749–761

Pituitary apoplexy: an overview of 186 cases published during the last century

Authors

    • Department of NeurosurgeryAdnan Menderes University Hospital
    • Cumhuriyet MahallesiAdnan Menderes Bulvarı
  • Yelda Özsunar
    • Department of RadiologyAdnan Menderes University Hospital
  • Sema Başak
    • Department of Throat, Nose, and EarAdnan Menderes University Hospital
  • Engin Güney
    • Department of EndocrinologyAdnan Menderes University Hospital
  • Erkin Kır
    • Department of OphthalmologyAdnan Menderes University Hospital
  • İbrahim Meteoğlu
    • Department of PathologyAdnan Menderes University Hospital
Review Article

DOI: 10.1007/s00701-009-0595-8

Cite this article as:
Turgut, M., Özsunar, Y., Başak, S. et al. Acta Neurochir (2010) 152: 749. doi:10.1007/s00701-009-0595-8

Abstract

Background

Pituitary apoplexy is a rare and life-threatening complication occurring in 0.6–10.5% of all cases of pituitary adenomas. Although the association between pituitary apoplexy and visual dysfunction has been recognized for a long time, the optimal management of this problem still remains controversial. The purpose of this overview was to present the surgical experience by analyzing the literature on the management of pituitary apoplexy for better treatment of these cases.

Materials and method

To establish a new guideline for the surgical treatment of this entity, publications reported during the last century and databases containing medical literature were analyzed. In addition, an illustrative case with pituitary apoplexy presenting with complaints of sudden onset severe headache associated with nausea, vomiting, and a sudden loss of vision was described. In fact, the experience in our complicated patient prompted us to review the available literature on the management of pituitary apoplexy to date.

Conclusions

Based on an overview of 186 cases of apoplectic pituitary adenoma presenting with monocular or binocular blindness, we highlight the importance of correct diagnosis and an early, but not necessarily emergency, surgery within the first week of admission to optimize visual outcome of such patients. The illustrative case further exemplifies the value of close interaction between members of the management team for optimal outcome.

Keywords

Pituitary tumorEndoscopyPituitary apoplexyTranssphenoidal surgeryVisual loss

Copyright information

© Springer-Verlag 2010