Surgical Outcomes of Pituitary Apoplexy.
- Author:
Jin Kyung KIM
1
;
Bong Jin PARK
;
Keun Tae CHO
;
Sang Koo LEE
;
Maeng Ki CHO
;
Young Joon KIM
Author Information
1. Department of Neurosurgery, Dankook University College of Medicine, Cheonan, Korea.
- Publication Type:Original Article
- Keywords:
Pituitary apoplexy;
Transsphenoidal approach;
Surgical outcome
- MeSH:
Acromegaly;
Cerebrospinal Fluid;
Follow-Up Studies;
Headache;
Hemorrhage;
Hormone Replacement Therapy;
Humans;
Hypopituitarism;
Infarction;
Pituitary ACTH Hypersecretion;
Pituitary Apoplexy*;
Pituitary Neoplasms;
Postoperative Complications;
Prolactinoma;
Sepsis;
Thyroid Gland;
Visual Acuity;
Visual Fields
- From:Journal of Korean Neurosurgical Society
2005;38(6):450-455
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: Pituitary apoplexy is a rare clinical syndrome caused by pituitary hemorrhage, hemorrhagic infarction, or ischemic infarction within a pituitary tumor or surrounding structure. We analyzed surgical outcomes of pituitary apoplexy. METHODS: From 1995 to 2004, we reviewed our experience of 29 cases with pituitary apoplexy. In all patients, pre- and postoperative clinical presentation were checked and endocrine study were performed. RESULTS: The most frequent symptoms were visual disturbance (24 cases, 82.8%) and headache (22 cases, 75.9%). After surgery, headache improved in 86.4%, 88.9% among 18cases who had preoperative reduction in visual acuity and 75.0% among 12 cases who had preoperative reduction in visual field improved. In endocrine study, long-term steroid and thyroid hormone replacement therapy was necessary in 42.9% of 14 cases presenting preoperative hypopituitarism. Postoperative transient hypopituitarism developed in 5 cases (33.3%) and they all recovered in follow up study. Postoperative endocrinological recovery were in 77.9% of 9 cases with preoperative prolactinoma, 1 case in 2 cases with acromegaly and one case with Cushing disease. Postoperative complications were diabetes inspidus(DI) in 1 case (3.4%), cerebrospinal fluid (CSF) leakage in 2 cases (6.8%) and death in 1 case (3.4%) due to sepsis. CONCLUSION: We report good results through surgery of pituitary apoplexy in a clinical and endocrine outcomes. The surgery should be performed as soon as possible to be a suitable method for treating pituitary apoplexy.
