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Pituitary Apoplexy

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Book cover Endocrine Emergencies

Part of the book series: Contemporary Endocrinology ((COE,volume 74))

Abstract

Pituitary apoplexy is an acute clinical syndrome of pituitary infarction, hemorrhage, and/or necrosis presenting as abrupt onset headache, nausea and vomiting, fever, meningismus, visual disturbances, and altered sensorium. The syndrome is often accompanied by varying degrees of transient or persistent hypopituitarism. Without proper recognition and treatment, this condition may be life-threatening. A preexisting pituitary adenoma is the most often cause of apoplexy, often precipitated by known risk factors. Although imaging findings and pathological assessments may aid in diagnosis, the syndrome is defined by its clinical presentation due to blood extravasation and pituitary necrosis with compressive effects on the pituitary and nearby neurological structures. Management is aimed at normalization of electrolytes, fluid resuscitation, rapid replacement of the adrenal axis with high-dose corticosteroids, and timely decompressive surgery when indicated.

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Authors and Affiliations

  1. Division of Endocrinology, Diabetes, and Metabolism, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Becker Bldg., Room 131, Los Angeles, CA, 90048, USA

    Shlomo Melmed M.D.

  2. Cedars-Sinai Medical Center, 8700 Beverly Boulevard #2015, Los Angeles, CA, 90048, USA

    Pouyan Famini M.D.

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Correspondence to Shlomo Melmed M.D. .

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    Lynn Loriaux

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Famini, P., Melmed, S. (2014). Pituitary Apoplexy. In: Loriaux, L. (eds) Endocrine Emergencies. Contemporary Endocrinology, vol 74. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-697-9_17

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