Humans ; Male ; Pituitary Apoplexy ; diagnosis

Cause of pituitary apoplexy has been known as hemorrhage, hemorrhagic infarction or infarction of pituitary adenoma or adjacent tissues of pituitary gland. However, pituitary apoplexy caused by pure infarction of pituitary adenoma has been rarely reported. Here, we present the two cases pituitary apoplexies caused by pituitary adenoma infarction that were confirmed by transsphenoidal approach (TSA) and pathologic reports. Pathologic report of first case revealed total tumor infarction of a nonfunctioning pituitary macroadenoma and second case partial tumor infarction of ACTH secreting pituitary macroadenoma. Patients with pituitary apoplexy which was caused by pituitary adenoma infarction unrelated to hemorrhage or hemorrhagic infarction showed good response to TSA treatment. Further study on the predisposing factors of pituitary apoplexy and the mechanism of infarction in pituitary adenoma is necessary.
Adrenocorticotropic Hormone ; Hemorrhage ; Humans ; Infarction ; Pituitary Apoplexy ; Pituitary Gland ; Pituitary Neoplasms

Postpartum ischemic necrosis of the pituitary gland, known as Sheehan's syndrome, is well-established clinical entity. The recent progress in radiological imaging allows an easy and noninvasive study of the pituitary area in the patients while still alive. An empty or partially empty sella is a constant feature of Sheehan's syndrome in the later phase. We report a case of nonhemorrhagic postpartum pituitary infarction documented in the acute phase with clinical, endocrine, and sequential magnetic resonance (MR) imaging studies.
Humans ; Hypopituitarism* ; Infarction ; Necrosis ; Pituitary Apoplexy* ; Pituitary Gland ; Pituitary Neoplasms* ; Postpartum Period

OBJECTIVES: Pituitary apoplexy is a well-described clinical syndrome resulting from pituitary hemorrhage, hemorrhagic infarction, or infarction, almost invariably occurring in the presence of an adenoma. We analyzed pituitary apoplexy with an emphasis on clinical presentation, pathology and predisposing factors. METHODS: We reviewed 35 histologically proven pituitary adenomas, operated from January 1995 to August 1999, to select 8 cases which showed clinical or operative findings compatible with pituitary apoplexy. These patients were analyzed in terms of symptom and sign, hormonal status, and predisposing factors, pathologic findings. RESULTS: Among 35 surgically treated tumors of the pituitary gland, 8 cases(23%) were diagnosed as pituitary apoplexy. The pathologic findings revealed hemorrhage(7 cases) and infarction(1 case) of pituitary adenomas. One case had predisposing factor of appendectomy. The most common presenting symptom and sign were sudden severe headache and visual disturbance. CONCLUSION: We treated pituitary apoplexy surgically and obtained good outcomes. Pituitary apoplexy due to massive infarction of the pituitary gland is very rare condition but surgical treatment by trans-spheniodal surgery showed a good result.
Adenoma ; Appendectomy ; Causality ; Headache ; Hemorrhage ; Humans ; Infarction ; Pathology ; Pituitary Apoplexy* ; Pituitary Gland ; Pituitary Neoplasms

We encountered a case of pituitary apoplexy who presented with isolated headache and vomiting without visual disturbance or ophthalmoplegia. The cerebrospinal fluid examination was compatible with aseptic meningitis. A computed tomography revealed slightly high density in the pituitary fossa and suprasella area, but the signal change was very faint. Our case suggests that clinicians should take into account the possibility of pituitary apoplexy without visual disturbance or ophthalmoplegia, when aseptic meningitis is suspected.
Headache ; Meningitis ; Meningitis, Aseptic ; Ophthalmoplegia ; Pituitary Apoplexy ; Vomiting

Pituitary apoplexy refers to a clinical syndrome characterized by sudden headache, visual impairmentm and ophthalmoplegia, which are caused by infarction or hemorrhage of the pituitary tumor. There is disagreement regarding the role of early surgery. All the patients may not require surgical decompression because spontaneous recovery is possible. We report 4 cases of pituitary tumor showing spontaneous resolution after pituitary apoplexy treated only by hormonalreplacement therapy.
Decompression, Surgical ; Headache ; Hemorrhage ; Humans ; Infarction ; Ophthalmoplegia ; Pituitary Apoplexy* ; Pituitary Neoplasms

The occurrence of symptomatic pituitary hemorrhage into a Rathke's cleft cyst (RCC) is extremely rare. The author reports an interesting case of intra- and suprasellar RCC presented with features of pituitary apoplexy. This 62-year-old woman suffered acute headache, mental confusion, and partial hypopituitarism. The characteristics of the magnetic resonance imaging seemed most compatible with a hemorrhagic pituitary adenoma. Transsphenoidal drainage of the cyst contents confirmed the diagnosis of hemorrhagic RCC and resolved the symptoms. All published data on this rare clinical entity are extracted and reviewed.
Drainage ; Female ; Headache ; Hemorrhage ; Humans ; Hypopituitarism ; Magnetic Resonance Imaging ; Middle Aged ; Pituitary Apoplexy ; Pituitary Neoplasms ; Stroke

Pituitary apoplexy is a life-threatening condition resulting from hemorrhage or necrosis of a pituitary tumor with subsequent compression of the optic nerves and cavernous sinuses. This is the first case report of a patient who experienced pituitary apoplexy due to hemorrhage of pituitary adenoma, which was initially recognized during pregnancy, and submitted to minimally invasive neuroendoscopic transnasal transsphenoidal approach in the third trimester of pregnancy.
Cavernous Sinus ; Female ; Hemorrhage ; Humans ; Necrosis ; Optic Nerve ; Pituitary Apoplexy* ; Pituitary Neoplasms ; Pregnancy Trimester, Third ; Pregnancy*

Adolescent ; Female ; Humans ; Pituitary Apoplexy ; complications ; physiopathology ; Pituitary Diseases ; etiology ; physiopathology

Pituitary apoplexy, the sudden infarction, necrosis or hemorrhage into a pituitary adenoma may be threatening life and is difficult to diagnose. With an advent of CT, early diagnosis of hemorrhage into the pituitary adenomais possible if one has familiarity with its characteristic CT changes. Two cases of pituitary apoplexy are reported with brief review of the literatures. One case had a history of radiation therapy for pituitary adenoma 7 years ago, and the other had no symptoms or sings of pituitary tumor prior to onset of disease.
Early Diagnosis ; Hemorrhage ; Infarction ; Necrosis ; Pituitary Apoplexy ; Pituitary Neoplasms ; Recognition (Psychology)