Toggle Main Menu Toggle Search

Open Access padlockePrints

Pituitary apoplexy: A review of clinical presentation, management and outcome in 45 cases

Lookup NU author(s): Dr Latika Sibal, Dr Stephen Ball, Dr Vincent Connolly, Dr Robert James, Philip Kane, Dr William Kelly, Professor Pat Kendall-Taylor, David Mathias, Dr Petros PerrosORCiD, Dr Richard Quinton, Dr Bijayeswar Vaidya

Downloads

Full text for this publication is not currently held within this repository. Alternative links are provided below where available.


Abstract

Objective: To review clinical presentation, management and outcomes following different therapies in patients with pituitary apoplexy. Methods: Retrospective analysis of case-records of patients with classical pituitary apoplexy treated in our hospitals between 1983-2004. Results: Forty-five patients (28 men; mean age 49 years, range 16-72 years) were identified. Only 8 (18%) were known to have pituitary adenomas at presentation. Thirty-four (81%) patients had hypopituitarism at presentation. CT and MRI identified pituitary apoplexy in 28% and 91% cases, respectively. Twenty-seven (60%) patients underwent surgical decompression, whilst 18 (40%) were managed conservatively. Median time from presentation to surgery was 6 days (range 1-121 days). Patients with visual field defects were more likely than those without these signs to be managed surgically (p = 0.01). Complete or near-complete resolution occurred in 93% (13/14), 94% (15/16) and 93% (13/14) of the surgically treated patients with reduced visual acuity, visual field deficit and ocular palsy, respectively. All patients with reduced visual acuity (4/4), visual field deficit (4/4) and ocular palsy (8/8) in the conservative group had complete or near-complete recovery. Only 5 (19%) patients in the surgical group and 2 (11%) in the conservative group had normal pituitary function at follow up. One (4%) patient in the surgical group and 4 (22%) in the conservative group had a recurrence of pituitary adenoma. Conclusions: This large series suggests that the patients with classical pituitary apoplexy, who are without neuro-ophthalmic signs or exhibit mild and non-progressive signs, can be managed conservatively in the acute stage. © Springer Science + Business Media, Inc. 2005.


Publication metadata

Author(s): Sibal L, Ball SG, Connolly V, James RA, Kane P, Kelly WF, Kendall-Taylor P, Mathias D, Perros P, Quinton R, Vaidya B

Publication type: Article

Publication status: Published

Journal: Pituitary

Year: 2004

Volume: 7

Issue: 3

Pages: 157-163

ISSN (print): 1386-341X

ISSN (electronic): 1573-7403

Publisher: Springer New York LLC

URL: http://dx.doi.org/10.1007/s11102-005-1050-3

DOI: 10.1007/s11102-005-1050-3

PubMed id: 16010459


Altmetrics

Altmetrics provided by Altmetric


Share