Endoscopic Endonasal Transsphenoidal Resection for Pituitary Apoplexy during the Third Trimester of Pregnancy.
Pituitary apoplexy is an uncommon phenomenon typically characterized by vascular insufficiency or acute hemorrhage into a pituitary adenoma. The overall incidence of pituitary apoplexy ranges between 1 and 25% of all pituitary adenomas. With the widespread use of MRI technology, the diagnosis of asymptomatic intratumoral hemorrhage is closer to 10%. The authors report a case of a 27-year-old female in her 36th week of pregnancy who presented with severe onset headache and acute left-sided vision loss. MRI of the brain revealed a large hemorrhagic mass occupying the sella turcica. The patient underwent an emergent endoscopic endonasal transsphenoidal resection for pituitary apoplexy. Postoperatively, the patient's neurologic deficit resolved. Minimally invasive endoscopic endonasal transsphenoidal resection of pituitary apoplexy can be safely utilized in third trimester pregnant women presenting with acute severe neurologic deficits.
Department of Neurosurgery, Montefiore Medical Center, 3316 Rochambeau Avenue, Bronx, NY 10467, USA.
Adesh
0000-0001-7946-9669
A
Tandon
American Center for Spine and Neurosurgery, Libertyville, IL, USA.
Juan
J
Alzate
Department of Neurosurgery, Montefiore Medical Center, 3316 Rochambeau Avenue, Bronx, NY 10467, USA.
Patrick
P
LaSala
Department of Otorhinolaryngology, Montefiore Medical Center, Bronx, NY, USA.
Marvin P
MP
Fried