Pituitary apoplexy: an overview of 186 cases published during the last century.
BACKGROUND
Pituitary apoplexy is a rare and life-threatening complication occurring in 0.6-10.5% of all cases of pituitary adenomas. Although the association between pituitary apoplexy and visual dysfunction has been recognized for a long time, the optimal management of this problem still remains controversial. The purpose of this overview was to present the surgical experience by analyzing the literature on the management of pituitary apoplexy for better treatment of these cases.


METHODS
To establish a new guideline for the surgical treatment of this entity, publications reported during the last century and databases containing medical literature were analyzed. In addition, an illustrative case with pituitary apoplexy presenting with complaints of sudden onset severe headache associated with nausea, vomiting, and a sudden loss of vision was described. In fact, the experience in our complicated patient prompted us to review the available literature on the management of pituitary apoplexy to date.


CONCLUSIONS
Based on an overview of 186 cases of apoplectic pituitary adenoma presenting with monocular or binocular blindness, we highlight the importance of correct diagnosis and an early, but not necessarily emergency, surgery within the first week of admission to optimize visual outcome of such patients. The illustrative case further exemplifies the value of close interaction between members of the management team for optimal outcome.
Turgut
Mehmet
M
Department of Neurosurgery, Adnan Menderes University Hospital, Aydin, Turkey. drmturgut@yahoo.com
Ozsunar
Yelda
Y
Başak
Sema
S
Güney
Engin
E
Kir
Erkin
E
Meteoğlu
Ibrahim
I
D000236:Adenoma / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D000328:Adult; D001766:Blindness / Q000209:etiology* / Q000503:physiopathology; D042241:Early Diagnosis; D004724:Endoscopy / Q000379:methods; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D008297:Male; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods; D009900:Optic Nerve / Q000098:blood supply / Q000473:pathology / Q000503:physiopathology; D010899:Pituitary Apoplexy / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D010902:Pituitary Gland / Q000098:blood supply / Q000473:pathology / Q000601:surgery; D010911:Pituitary Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000473:pathology / Q000503:physiopathology