title: Pituitary apoplexy: considerations on a single center experience and review of the literature.
abstract: OBJECTIVE
  To present a single-center experience on pituitary tumor apoplexy and a review of literature focusing on predisposing and precipitating factors.
  
  
  METHODS
  Clinical presentation of our series of cases. Contemporary published literature is also reviewed.
  
  
  RESULTS
  The definition of this syndrome has not been consistent although now the majority of authors agree to definite it as an acute condition caused by hemorrhage or infarction of a pre-existing pituitary adenoma. Different predisposing and precipitating factors have been described in literature; among these antithrombotic and anticoagulant drugs, seem to play relevant roles. The clinical cases observed in our clinic confirm these data and suggest a probable association between elderly patients taking anticoagulant therapy and pituitary apoplexy adenoma.
  
  
  CONCLUSIONS
  Pituitary tumor apoplexy remains a challenging disease in relation to difficulties in correct diagnosis and thus in appropriate treatment. Antithrombotic/anticoagulant therapy may have an important role as precipitating factor. When a pituitary disorder is known, great care should be taken in the prescription of anticoagulant therapy.
authors.affiliation: Unit of Neurosurgery - Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.|Department of Pathophysiology and Organ Transplantation, University of Milan, Milan, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Giammattei
authors.affiliation: Unit of Endocrinology - Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.|Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Mantovani
authors.affiliation: Unit of Neurosurgery - Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Carrabba
authors.affiliation: Unit of Pathology - Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.|Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Ferrero
authors.affiliation: Unit of Neurosurgery - Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.|Department of Pathophysiology and Organ Transplantation, University of Milan, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Di Cristofori
authors.affiliation: Unit of Endocrinology - Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.|Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Verrua
authors.affiliation: Unit of Otolaringology - Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.|Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Guastella
authors.affiliation: Unit of Otolaringology - Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.|Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Pignataro
authors.affiliation: Unit of Neurosurgery - Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Rampini
authors.affiliation: Unit of Neurosurgery - Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. marina.minichiello@unimi.it.|Department of Pathophysiology and Organ Transplantation, University of Milan, Milan, Italy. marina.minichiello@unimi.it.
authors.forename: M
authors.initials: M
authors.lastname: Minichiello
authors.affiliation: Unit of Neurosurgery - Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Locatelli
mesh_terms: D002986:Clinical Trials as Topic; D006801:Humans; D010899:Pituitary Apoplexy / Q000175:diagnosis* / Q000628:therapy*
keywords: Anticoagulant therapy; Apoplexy; Pituitary; Review