Diagnosis and management of pituitary apoplexy
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Keywords

endocrine
management
pituitary adenoma
pituitary apoplexy

How to Cite

Orrego, A., & Jácome, A. (2019). Diagnosis and management of pituitary apoplexy. Revista Colombiana De Endocrinología, Diabetes &Amp; Metabolismo, 6(3), 188–197. https://doi.org/10.53853/encr.6.3.533

Abstract

Pituitary apoplexy is characterized by ischemic infarction or hemorrhage into an adenoma. Although, it occurs spontaneously in pre-existing pituitary adenomas in most cases; hypertension, pregnancy, bromocriptine, hypothalamic releasing hormones for preoperative testing, pituitary irradiation and heart surgery have been identified as precipitating factors. Classical pituitary apoplexy is a medical emergency and rapid replacement with hydrocortisone maybe life-saving. Patients develop sudden headache, vomiting, meningeal signs, visual impairment, and may be a decrease in the level of consciousness. Neurological symptoms may or not be present, the latter involving the second, third, fourth and sixth cranial nerves. It is necessary to perform a brain MRI for diagnosis. Whether to treat surgically or conservatively is a matter of discussion, but most are inclined for the first approach. It all depends on the progression and aggressiveness of symptoms, and if so happens, surgical treatment consists in emergency sellar decompression by transsphenoidal surgery and replacement therapy with steroids. Conservative management and careful monitoring for recurrence of tumor growth, plus treatment of endocrine dysfunction are an adequate alternative when symptoms ameliorate and remain stable or disappear thereafter

https://doi.org/10.53853/encr.6.3.533
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References

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