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Postoperative Pituitary Apoplexy

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Pituitary Apoplexy

Abstract

Pituitary apoplexy is a rare and potentially life-threatening condition caused by sudden haemorrhage or infarction of the pituitary gland. Postoperative pituitary apoplexy is massive swelling and haemorrhage in a pituitary tumour following a subtotal resection of giant pituitary adenomas. In this article, the authors review the etiopathogenesis, clinical features, imaging, differential diagnoses and management of this uncommon condition.

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Abbreviations

ACTH:

Adrenocorticotrophic hormone

CT:

Computerized tomography

GH:

Growth hormone

MRI:

Magnetic resonance imaging

References

  • Ahmad FU, Pandey P, Mahapatra AK. Post operative ‘pituitary apoplexy’ in giant pituitary adenomas: a series of cases. Neurol India. 2005;53:326–8.

    Article  PubMed  Google Scholar 

  • Bills DC, Meyer FB, Laws Jr ER, Davis DH, Ebersold MJ, Scheithauer BW, Ilstrup DM, Abboud CF. A retrospective analysis of pituitary apoplexy. Neurosurgery. 1993;33:602–9.

    Article  PubMed  CAS  Google Scholar 

  • Biousse V, Newman NJ, Oyesiku NM. Precipitating factors in pituitary apoplexy. J Neurol Neurosurg Psychiatry. 2001;71:542–5.

    Article  PubMed  CAS  Google Scholar 

  • Bleibtreu L. Ein Fall von Akromegalie (Zerstoerung der Hypophysis durch Blutung). Munch Med Wochenschr. 1905;52:2079–80.

    Google Scholar 

  • Brougham M, Heusner AP, Adams RD. Acute degenerative changes in adenomas of the pituitary body – with special reference to pituitary apoplexy. J Neurosurg. 1950;7:421–39.

    Article  PubMed  CAS  Google Scholar 

  • Cardoso ER, Peterson EW. Pituitary apoplexy: a review. Neurosurgery. 1984;14:363–73.

    Article  PubMed  CAS  Google Scholar 

  • Chacko AG, Chacko G, Seshadri MS, Chandy MJ. Hemorrhagic necrosis of pituitary adenomas. Neurol India. 2002;50:490–3.

    PubMed  CAS  Google Scholar 

  • Chang CV, Felicio AC, Toscanini AC, Teixeira MJ, Cunha-Neto MB. Pituitary tumor apoplexy. Arq Neuropsiquiatr. 2009;67:328–33.

    Article  PubMed  Google Scholar 

  • Cunha-Neto MBC, Musolino NRC, Toscanini AC. Síndrome da sela vazia e apoplexia hipofisária. In: Saad MJA, Maciel RMB, Mendonça BB, editors. Endocrinologia. São Paulo: Editora Atheneu; 2007. p. 47–62.

    Google Scholar 

  • Dingley LA, Lond MD. Sudden death due to a tumor of the pituitary gland. Lancet. 1932;23:183–4.

    Article  Google Scholar 

  • Dubuisson AS, Beckers A, Stevenaert A. Classical pituitary tumour apoplexy: clinical features, management and outcomes in a series of 24 patients. Clin Neurol Neurosurg. 2007;109:63–70.

    Article  PubMed  Google Scholar 

  • Ebersold MJ, Laws Jr ER, Scheithauer BW, Randall RV. Pituitary apoplexy treated by transsphenoidal surgery. J Neurosurg. 1983;58:315–20.

    Article  PubMed  CAS  Google Scholar 

  • Elsässer Imboden PN, De Tribolet N, Lobrinus A, Gaillard RC, Portmann L, Pralong F, Gomez F. Apoplexy in pituitary macroadenoma: eight patients presenting in 12 months. Medicine. 2005;84:188–96.

    Article  PubMed  Google Scholar 

  • Fraioli B, Esposito V, Palma L, Cantore G. Hemorrhagic pituitary adenomas: clinicopathological features and surgical treatment. Neurosurgery. 1990;27:741–7.

    Article  PubMed  CAS  Google Scholar 

  • Goel A, Deogaonkar M, Desai K. Fatal postoperative pituitary apoplexy: its case and management. Br J Neurosurg. 1995;9:37–40.

    Article  PubMed  CAS  Google Scholar 

  • Kasliwal MK, Srivastava R, Sinha S, Kale SS, Sharma BS. Vasospasm after transsphenoidal pituitary surgery: a case report and review of the literature. Neurol India. 2008;56:81–3.

    Article  PubMed  Google Scholar 

  • Kurwale NS, Ahmad F, Suri A, Kale SS, Sharma BS, Mahapatra AK, Suri V, Sharma MC. Post operative pituitary apoplexy: preoperative considerations toward preventing nightmare. Br J Neurosurg. 2012;26:59–63.

    Article  PubMed  Google Scholar 

  • Lazaro CM, Guo WY, Sami M, Hindmarsh T, Ericson K, Hulting AL, Wersäll J. Haemorrhagic pituitary tumors. Neuroradiology. 1994;36:111–4.

    Article  PubMed  CAS  Google Scholar 

  • McFadzean RM, Doyle D, Rampling R, Teasdale E, Teasdale G. Pituitary apoplexy and its effect on vision. Neurosurgery. 1991;29:669–75.

    Article  PubMed  CAS  Google Scholar 

  • Mohr G, Hardy J. Hemorrhage, necrosis, and apoplexy in pituitary adenomas. Surg Neurol. 1982;18:181–9.

    Article  PubMed  CAS  Google Scholar 

  • Nawar RN, AbdelMannan D, Selma WR, Arafah BM. Pituitary tumor apoplexy: a review. J Intensive Care Med. 2008;23:75–89.

    Article  PubMed  Google Scholar 

  • Onesti ST, Wisniewsky T, Post RKD. Clinical versus subclinical pituitary apoplexy: presentation, surgical management and outcome in 21 patients. Neurosurgery. 1990;21:980–6.

    Google Scholar 

  • Randeva HP, Schoebel J, Byrnet J, Esiri M, Adams CB, Wass JA. Classical pituitary apoplexy: clinical features, management and outcome. Clin Endocrinol (Oxf). 1999;51:181–8.

    Article  CAS  Google Scholar 

  • Semple PL, de Villiers JC, Bowen RM, Lopes MBS, Laws Jr ER. Pituitary apoplexy: do histological features influence the clinical presentation and outcome? J Neurosurg. 2006;104:931–7.

    Article  PubMed  Google Scholar 

  • Semple PL, Jane Jr JA, Laws Jr ER. Clinical relevance of precipitating factors in pituitary apoplexy. Neurosurgery. 2007;61:956–61.

    Article  PubMed  Google Scholar 

  • Semple PL, Jane JA, Lopes MB, Laws ER. Pituitary apoplexy: correlation between magnetic resonance imaging and histopathological results. J Neurosurg. 2008;108:909–15.

    Article  PubMed  Google Scholar 

  • Semple PL, Webb WK, de Villiers JC, Laws Jr ER. Pituitary apoplexy. Neurosurgery. 2005;56:65–73.

    PubMed  Google Scholar 

  • Turgut M, Ozsunar Y, BaÅŸak S, Güney E, Kir E, MeteoÄŸlu I. Pituitary apoplexy: an overview of 186 cases published during the last century. Acta Neurochir (Wien). 2010;152:749–61.

    Article  Google Scholar 

  • Veldhuis JD, Hammond JM. Endocrine function after spontaneous infarction of the human pituitary: report, review and reappraisal. Endocr Rev. 1980;1:100–7.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Ashok Kumar Mahapatra MS, MCh .

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Borkar, S.A., Mahapatra, A.K. (2014). Postoperative Pituitary Apoplexy. In: Turgut, M., Mahapatra, A., Powell, M., Muthukumar, N. (eds) Pituitary Apoplexy. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-38508-7_6

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  • DOI: https://doi.org/10.1007/978-3-642-38508-7_6

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-38507-0

  • Online ISBN: 978-3-642-38508-7

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