Pituitary apoplexy: pathophysiology, diagnosis and management
Arch. endocrinol. metab. (Online)
;
59(3): 259-264, 06/2015. tab, graf
Article
in English
| LILACS
| ID: lil-751323
ABSTRACT
Pituitary apoplexy is characterized by sudden increase in pituitary gland volume secondary to ischemia and/or necrosis, usually in a pituitary adenoma. Most cases occur during the 5th decade of life, predominantly in males and in previously unknown clinically non-functioning pituitary adenomas. There are some predisposing factors as arterial hypertension, anticoagulant therapy and major surgery. Clinical picture comprises headache, visual impairment, cranial nerve palsies and hypopituitarism. Most cases improve with both surgical and expectant management and the best approach in the acute phase is still controversial. Surgery, usually by transsphenoidal route, is indicated if consciousness and/or vision are impaired, despite glucocorticoid replacement and electrolyte support. Pituitary function is impaired in most patients before apoplexy and ACTH deficiency is common, which makes glucocorticoid replacement needed in most cases. Pituitary deficiencies, once established, usually do not recover, regardless the treatment. Sellar imaging and endocrinological function must be periodic reevaluated. Arch Endocrinol Metab. 2015;59(3)259-64.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Prostatic Neoplasms
/
Randomized Controlled Trials as Topic
/
Data Interpretation, Statistical
/
Models, Statistical
/
Salvage Therapy
/
Prostate-Specific Antigen
Type of study:
Controlled clinical trial
/
Diagnostic study
/
Prognostic study
Limits:
Humans
/
Male
Language:
English
Journal:
Arch. endocrinol. metab. (Online)
Journal subject:
Endocrinology
/
Metabolism
Year:
2015
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
University of Sao Paulo/BR
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