An investigation on clinical typing of pituitary apoplexy based on the analysis of pathologic, image, and clinical manifestations
10.3760/cma.j.issn.1000-6699.2015.06.012
- VernacularTitle:基于病理、影像及临床表现的垂体卒中的临床分型探讨
- Author:
Wensheng JIN
;
Hongmei LI
;
Jia LI
;
Zhuona YIN
;
Weiguo XU
;
Song ZHANG
;
Xiaopeng ZHANG
;
Guoliang WANG
;
Lixin HAN
;
Qiulin LIAO
- Publication Type:Journal Article
- Keywords:
Pituitary apoplexy;
Pituitary tumor;
Hypopituitarism;
Magnetic resonance imaging
- From:
Chinese Journal of Endocrinology and Metabolism
2015;(6):524-527
- CountryChina
- Language:Chinese
-
Abstract:
[Summary] Sixty-one patients suffering from pituitary apoplexy( PA) were mainly diagnosed according to pathologic findings, and were collected from case record, pathology, and MRI databases. They were classified into 4 types according to the clinical condition: the insidious type was characterized with only positive pathological findings;the asymptomatic type had both positive pathologic and MRI findings; the subacute type had PA associated symptoms longer than 2 weeks; and the acute type had PA associated symptoms for 2 weeks or less. The latter 2 types had positive pathological and MRI findings additionally. The basic lesions, acute or chronic symptoms, endocrinopathies and MRI findings were compared among 4 types. Results showed as followed. In all patients, there were headache(60. 7% ), blurred vision(55. 7% ), vomiting(21. 3% ), and dizziness(14. 8% ). Apoplexy associated symptoms comprised severe headache (24. 6% ), rapid vision loss (29. 5% ), and blepharopotosis or diplopia (9. 83% ). Insidious, asymptomatic, subacute, and acute types were composed of 15 (24. 6% ), 9 (14. 8% ), 19 (31. 1% ), and 18 (29. 5% ) cases, respectively. Aging and intracranial space-occupying symptoms as first complaint showed increasing trend from mild to severe types(both P<0. 05), while in chronic course it showed decreasing trend(P<0. 05). Acute massive symptoms(P<0. 01), and non-functional tumor(P<0. 01) in the 2 clinical types were much more frequent than in the two mild types. Half or more pituitary-target glands showed impaired functions in each type, and the impairment showed increasing trend through mild to severe types(P<0. 01). The present study provided a brief typing system in order to expand PA concept to a wider span covering various conditions. Some differences in tumor composition and endocrinopathies existed among the four types.
