UK guidelines for the management of pituitary apoplexy.
Classical pituitary apoplexy is a medical emergency and rapid replacement with hydrocortisone maybe life saving. It is a clinical syndrome characterized by the sudden onset of headache, vomiting, visual impairment and decreased consciousness caused by haemorrhage and/or infarction of the pituitary gland. It is associated with the sudden onset of headache accompanied or not by neurological symptoms involving the second, third, fourth and sixth cranial nerves. If diagnosed patients should be referred to a multidisciplinary team comprising, amongst others, a neurosurgeon and an endocrinologist. Apart from patients with worsening neurological symptoms in whom surgery is indicated, it is unclear currently for the majority of patients whether conservative or surgical management carries the best outcome. Post apoplexy, there needs to be careful monitoring for recurrence of tumour growth. It is suggested that further trials be carried out into the management of pituitary apoplexy to optimize treatment.
Churchill Hospital, Oxford, UK.
Senthil
S
Rajasekaran
Mark
M
Vanderpump
Stephanie
S
Baldeweg
Will
W
Drake
Narendra
N
Reddy
Marian
M
Lanyon
Andrew
A
Markey
Gordon
G
Plant
Michael
M
Powell
Saurabh
S
Sinha
John
J
Wass
D017408:Guidelines as Topic; D006801:Humans; D010899:Pituitary Apoplexy / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D010902:Pituitary Gland / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D006113:United Kingdom