title: Endoscopic surgical treatment for pituitary apoplexy in three elderly patients over the age of 80.
abstract: OBJECTIVE
  As the population continues to live longer, the diagnosis of pituitary adenoma-induced apoplexy becomes more common in the elderly. The standard treatment options for pituitary apoplexy are debatable. Although there is little information regarding the treatment of pituitary apoplexy in elderly patients, the optimal treatment needs to be determined for this age group. The current study examined the surgical treatment of pituitary apoplexy in three patients over the age of 80.
  
  
  METHODS
  Three patients over the age of 80 with pituitary apoplexy were admitted to our hospital. Some symptoms caused by pituitary apoplexy, including decreased visual acuity, double vision and oculomotor paresis, had persisted for more than 14 days. Magnetic resonance imaging revealed suprasellar mass lesions extending into the cavernous sinus. The general condition of the patients was good, and we performed endoscopic transsphenoidal surgery in each of these cases. The masses were removed, and the histological findings were diagnosed as non-functioning pituitary adenoma with presence of hemorrhagic or ischemic necrosis. Perioperative courses and general conditions were good, and the neurological deficits of each patient improved immediately.
  
  
  CONCLUSIONS
  Endoscopic transsphenoidal surgery has the advantage of visualization of the structures surrounding the pituitary gland. Moreover, the complication rate is relatively low because stress on the pituitary gland can be reduced by using this procedure. Even in patients over 80 years of age during the subacute phase, endoscopic surgical management is a good treatment candidate for pituitary apoplexy with mass lesion extension into the cavernous sinus.
authors: Department of Neurosurgery, Kumamoto University School of Medicine, 1-1-1 Honjo, 860-8556, Kumamoto, Japan.
authors: Yu
authors: Y
authors: Hasegawa
authors: Shigetoshi
authors: S
authors: Yano
authors: Tomotaka
authors: T
authors: Sakurama
authors: Yuki
authors: Y
authors: Ohmori
authors: Takayuki
authors: T
authors: Kawano
authors: Motohiro
authors: M
authors: Morioka
authors: Hank
authors: H
authors: Chen
authors: John H
authors: JH
authors: Zhang
authors: Jun-Ichi
authors: J
authors: Kuratsu
mesh_terms: D000368:Aged; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D010899:Pituitary Apoplexy / Q000473:pathology / Q000601:surgery*