Pituitary Apoplexy Associated with Cardiac Surgery

Pituitary Apoplexy: A Review of Clinical Presentation, Management and Outcome in 45 Cases

“…The development of apoplexy soon after a major surgery (one after coronary artery bypass graft) in 5 (11%) of our patients indicates that a major surgical operationparticularly cardiac surgery-is an important precipitant of pituitary apoplexy. It is thought that the haemodynamic instability and the use of anticoagulation (in cardiac surgery) during the surgical procedure may trigger apoplexy [20]. One patient developed pituitary apoplexy soon after stopping subcutaneous octreotide injections prescribed for acromegaly, which may be due to sudden enlargement of the pituitary tumour following cessation of the drug.…”

Blindness following pituitary apoplexy: Timing of surgery and neuro-ophthalmic outcome

“…13,22 Despite the fact that visual impairment is the most frequent and most important presentation of pituitary apoplexy, surprisingly, we found a paucity of published information on pituitary apoplexy in the peer-reviewed English-language literature, and many of the articles that did exist were case reports. 9,[23][24][25][26][27][28][29][30][31][32][33][34] The aim of this article is to report the visual and ophthalmoplegic outcomes following unilateral or bilateral blindness resulting from pituitary apoplexy.…”

Perioperative visual loss in ocular and nonocular surgery

“…We are aware of 33 cases in the literature of postoperative pituitary apoplexy ( Table 3). The majority of cases occurred following cardiac surgery, especially CABG, 111,[114][115][116][117][118][119][120][121][122][123][124] as well as mitral valve repair, 125 and aortic valve replacement. 126 Pituitary apoplexy was also seen following: abdominal aortic aneurysm repair; 127 liposuction; 128 knee arthroplasty; 129,130 hip arthroplasty; 114,130 spine surgery; 131 cholecystectomy; 132 orchiectomy; 114 and endoscopic sinus surgery.…”

“…137 Risk factors for developing postoperative stroke include: hypertension, diabetes mellitus, renal insufficiency, smoking history, COPD, peripheral vascular disease, cardiac disease, and/or systolic dysfunction. Patients with symptomatic carotid stenosis may be at increased risk of postoperative stroke, including cortical 114 65 M CABG 1 116 57 M CABG 1 116 55 M CABG 1 118 58 M CABG 1 118 65 M CABG 1 118 68 M CABG 1 122 72 M CABG 1 122 64 M CABG 1 123 79 M CABG 1 123 64 M CABG 1 183 77 M CABG 1 183 59 M CABG 1 117 70 M CABG 1 111 60 F CABG 1 119 61 M CABG 1 120 71 M CABG 1 121 60 M CABG 1 115 63 M CABG 1 115 62 M CABG 1 115 55 M CABG 1 125 56 M Mitral valve replacement 1 126 68; gender NA Aortic valve replacement 1 127 73 M Abdominal aortic aneurysm repair 1 129 65 F Knee arthroplasty 1 130 61 M Knee arthroplasty 1 114 72 M Hip arthroplasty 1 130 76 M Hip arthroplasty 1 131 45 M Spine surgery 1 128 50 F Liposuction 1 114 52 M Orchiectomy 1 132 47 M Cholecystectomy 1 110 67 M endoscopic sinus surgery…”