Document Detail


A retrospective analysis of pituitary apoplexy.
MedLine Citation:
PMID:  8232799     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Thirty-seven patients with pituitary apoplexy were analyzed with an emphasis on clinical presentation and visual outcome. Their mean age was 56.6 years, with a male to female ratio of 2:1. Presenting symptoms included headache (95%), vomiting (69%), ocular paresis (78%), and reduction in visual fields (64%) or acuities (52%). Computed tomographic scanning correctly identified pituitary hemorrhage in only 46% of those scanned. Thirty-six patients underwent transsphenoidal decompression. By immunostaining criteria, null-cell adenomas were the most frequent tumor type (50%). Long-term steroid or thyroid hormone replacement therapy was necessary in 82% and 89% of patients, respectively. Long-term desmopressin therapy was required in 11%, and 64% of the male patients required testosterone replacement therapy. Surgery resulted in improvement in visual acuity deficits in 88%, visual field deficits in 95%, and ocular paresis in 100%. Analysis of the degree of improvement in preoperative visual deficits with the timing of the surgery demonstrated that those who underwent surgery within a week of apoplexy had significant recovery in their visual acuities. In the stable, conscious patient with residual vision in each eye, surgical decompression should be performed as soon as possible, because delays beyond 1 week may retard the return of visual function.
Authors:
D C Bills; F B Meyer; E R Laws; D H Davis; M J Ebersold; B W Scheithauer; D M Ilstrup; C F Abboud
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  33     ISSN:  0148-396X     ISO Abbreviation:  Neurosurgery     Publication Date:  1993 Oct 
Date Detail:
Created Date:  1993-12-17     Completed Date:  1993-12-17     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  602-8; discussion 608-9     Citation Subset:  IM    
Affiliation:
Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota.
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MeSH Terms
Descriptor/Qualifier:
Adenoma / diagnosis,  pathology,  surgery*
Adult
Aged
Aged, 80 and over
Female
Follow-Up Studies
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Neurologic Examination
Pituitary Apoplexy / diagnosis,  pathology,  surgery*
Pituitary Gland / pathology
Pituitary Hormones / analysis
Pituitary Neoplasms / diagnosis,  pathology,  surgery*
Postoperative Complications / diagnosis
Tomography, X-Ray Computed
Chemical
Reg. No./Substance:
0/Pituitary Hormones

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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