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Effect of transsphenoidal surgery on decreased visual acuity caused by pituitary apoplexy

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Abstract

We treated 12 patients with pituitary apoplexy out of 103 patients with pituitary tumors from August 1994 to March 2008 in the Nishi-Kobe Medical Center. The male to female ratio was 1:2 and the average age was 43 years old, ranging from 19 to 73. The symptoms on presentation were a decrease of visual acuity in nine, headache in seven, endocrinological disturbance in six, visual field defect in seven, a febrile state in six, vomiting in four, oculomotor disturbance in two, abducens palsy in one, and transient altered consciousness in one. All patients underwent transsphenoidal surgery and, in four of these, surgery was conducted within 7 days after onset. All nine patients with a decrease in the visual acuity recovered (100%) and, in addition, complete or near-complete vision recovery was noted in six out of eight patients (75%), excluding one patient whom we were unable to examine accurately. Emergent surgery was performed for only two patients with an acute deterioration of the visual acuity, with one finally developing complete blindness. Based on this study, we conclude that decompressive surgery is very useful for decreased visual acuity caused by pituitary apoplexy, but it is not necessary to perform emergent surgery for pituitary apoplexy in the absence of severe visual deterioration.

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Abbreviations

Good:

Recovered nearly to the baseline acuity before onset

Fair:

Did not recover to the baseline acuity before onset

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Authors and Affiliations

  1. Department of Neurosurgery, Nishi-Kobe Medical Center, 5-7-1 Kouji-dai, Nishi-ku, Kobe City, Japan

    Naoya Takeda, Katsuzo Fujita, Shigenori Katayama, Nobuyuki Akutu & Shigeto Hayashi

  2. Department of Neurosurgery, Kobe University Graduate School of Medicine, Kobe City, Japan

    Eiji Kohmura

Authors
  1. Naoya Takeda
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  2. Katsuzo Fujita
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  3. Shigenori Katayama
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  4. Nobuyuki Akutu
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  5. Shigeto Hayashi
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  6. Eiji Kohmura
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Correspondence to Naoya Takeda.

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Takeda, N., Fujita, K., Katayama, S. et al. Effect of transsphenoidal surgery on decreased visual acuity caused by pituitary apoplexy. Pituitary 13, 154–159 (2010). https://doi.org/10.1007/s11102-009-0216-9

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  • DOI: https://doi.org/10.1007/s11102-009-0216-9

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