Pituitary apoplexy

Bi, Wenya Linda; Dunn, Ian F.; LawsJr., Edward R.

doi:10.1007/s12020-014-0359-y

Cited by 75 publications

(93 citation statements)

References 53 publications

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“…Classically, symptoms evolve from hours to two days after the onset of apoplexy, although a subacute course is described (28 Brain imaging is required to identify a pituitary lesion. Although cranial computed tomography (CT) scan is easier to obtain, it is less sensitive for diagnosis of pituitary lesions.…”

Section: Diagnosis and Managementmentioning

confidence: 99%

“…As ACTH deficiency is life-threatening condition, glucocorticoid replacement is recommended and a supraphysiological dose is indicated to control edema on parasellar structures: dexamethasone 8 to 16 mg per day or hydrocortisone 50 mg intravenously every 6 hours (30). Anterior pituitary deficiencies occur in nearly 80% of patients: ACTH in up to 70%, TSH in 50% and gonadotrophin in 75% of cases (14,28,31). Patients with low levels of prolactin exhibit a lower probability of pituitary function recovery after surgery.…”

Section: Diagnosis and Managementmentioning

confidence: 99%

“…Most PA cases improve with both surgical and expectant management and the most appropriate approach in the acute phase is controversial (28). Although guidelines, as the one from UK, proposed an algorithm for PA management, a randomized trial comparing both strategies is needed for strong evidence (2,29).…”

Section: Diagnosis and Managementmentioning

confidence: 99%

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Pituitary apoplexy: pathophysiology, diagnosis and management

Glezer

Bronstein

2015

Arch. Endocrinol. Metab.

112

108

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Pituitary apoplexy is characterized by sudden increase in pituitary gland volume secondary to is chemia and/or necrosis, usually in a pituitary adenoma. Most cases occur during the 5 th decade of life, predominantly in males and in previously unknown clinically non functioning pituitary adeno mas. There are some predisposing factors as arterial hypertension, anticoagulant therapy and major surgery. Clinical picture comprises headache, visual impairment, cranial nerve palsies and hypopitui tarism. 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 cons ciousness and/or vision are impaired, despite glucocorticoid replacement and electrolyte support. Pi tuitary 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

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Section: Diagnosis and Managementmentioning

confidence: 99%

Section: Diagnosis and Managementmentioning

confidence: 99%

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Pituitary apoplexy: pathophysiology, diagnosis and management

Glezer

Bronstein

2015

Arch. Endocrinol. Metab.

112

108

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“…Very frequently, affected patients have a macroadenoma undergoing drug therapy or are taking oral anticoagulants; however, in the majority of cases, no cause can be ascertained [25].…”

Section: Pituitary Apoplexy Etiologymentioning

confidence: 99%

Radiological Diagnosis and Differential Diagnosis of Headache

Langner¹,

Kirsch

2015

Fortschr Röntgenstr

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Headache is very common and affects almost everyone at some point. It is one of the most common disorders that leads patients to see their physician. All different forms have the nociception via trigeminal nerve fibers in common. Beside the clinical course headaches are classified as either primary or secondary, with the latter having an identifiable structural or biochemical cause. Imaging has a low diagnostic yield in primary headache but play an important role in the differential diagnosis of secondary forms. An overview of different forms of secondary headache is given, outlining diagnostic procedures and the morphologic imaging features of each syndrome. Key points: ??Headache can be differentiated in primary and secondary forms. ??Imaging plays an important role in differential diagnosis of secondary forms. ??Imaging should be performed in patients with concomitant systemic or neurologic symptoms. Citation Format: ??Langner S, Kirsch M, Hosten N Radiological Diagnosis and Differentialdiagnosis of Headache. Fortschr R?ntgenstr 2015; 187: 879???891

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“…1) [1,2]. With the objective of increasing the chances of complete recovery, the patient underwent removal of the hemorrhagic adenoma, achieved through an endoscopic endonasal trans-sphenoidal approach.…”

Section: ó Springer Science+business Media New York 2014mentioning

confidence: 99%