title: Post traumatic pituitary apoplexy with contiguous intra cerebral hematoma operated through endonasal route--a case report.
abstract: Pituitary apoplexy is a clinical syndrome occurring as a consequence of fulminant expansion of pituitary tumor due to massive infarction, necrosis, and hemorrhage. Its association with head injury is rare and only few reports are available. Shear forces on stalk and arterial vasospasm have been proposed to be the possible reasons. The clinical picture is characterized by sudden onset headache, visual symptoms, multiple cranial nerves involvement, meningismus, altered mental status, and hormonal dysfunction. Transsphenoidal decompression is the standard treatment but suprasellar and widespread extension of hematoma may need intracranial approach. We are reporting a rare association of head injury with pituitary apoplexy, where endonasal surgery proved to be a simple useful approach to evacuate contiguous intra-cerebral hematoma with excision of apoplectic pituitary adenoma.
authors.affiliation: Department of Neurosurgery, King George's Medical University, Lucknow 226003, India. ravidev@hotmail.com
authors.forename: Ravi
authors.initials: R
authors.lastname: Dev
authors.forename: Sunil Kumar
authors.initials: SK
authors.lastname: Singh
authors.forename: Mahesh Chandra
authors.initials: MC
authors.lastname: Sharma
authors.forename: Prakash
authors.initials: P
authors.lastname: Khetan
authors.forename: Ashish
authors.initials: A
authors.lastname: Chugh
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D020202:Cerebral Hemorrhage, Traumatic / Q000150:complications* / Q000473:pathology / Q000601:surgery*; D019299:Decompression, Surgical; D006801:Humans; D008297:Male; D009049:Motorcycles; D009296:Nasal Cavity / Q000601:surgery*; D010899:Pituitary Apoplexy / Q000209:etiology* / Q000473:pathology / Q000601:surgery*; D010902:Pituitary Gland / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed