AnatomyDiseasesChemicals and DrugsAnalytical, Diagnostic and Therapeutic Techniques and EquipmentPhenomena and ProcessesInformation ScienceHealth Care
Pituitary ApoplexyPituitary NeoplasmsPituitary DiseasesPituitary GlandAdenomaAdenoma, ChromophobeOculomotor Nerve DiseasesBlepharoptosisPituitary Function TestsProlactinomaSphenoid SinusSella TurcicaAdenoma, AcidophilCentral Nervous System CystsPituitary Gland, AnteriorRemission, SpontaneousAcromegalyMagnetic Resonance ImagingThyrotropin-Releasing HormoneAdrenocorticotropic HormoneHeadacheCushing SyndromeAdrenal InsufficiencyEncyclopedias as TopicIntensive CareHydrocortisoneHypotension
AdenomaAdenomasTumor apoplexyHemorrhageGlandPosterior pituitaryTumorsCavernousIschemicEndocrineHemorrhagicSymptomsIntracranialSymptomaticSubarachnoid spaceStalkMacroadenomaProlactinomasOpticOccursCommonlyLesionsGadoliniumComputed tomographySyndromeHormonalSuddenRarelyDiagnosisPRESENTATIONHormoneDiabetesCoronalAnteriorCompressionPatientsCerebrospinalConfusionFrequencyHormonesInvestigationsCasesAggressiveOutcomePatientDefectsConditionRare
Adenoma15
  • Almost all cases of pituitary apoplexy arise from a pituitary adenoma, a benign tumor of the pituitary gland. (wikipedia.org)
  • An existing pituitary adenoma usually is present. (medscape.com)
  • Pituitary apoplexy stems from an acute expansion of a pituitary adenoma or, less commonly, in a nonadenomatous gland from infarction or hemorrhage. (medscape.com)
  • We presented a case with a 54 × 40 × 40 mm pituitary adenoma and optic chiasmatic compression with left sphenoid sinus invasion. (nel.edu)
  • Histology of the pituitary lesion showed a typical eosinophilic adenoma which only secreted GH when tested with specific immunostain. (nel.edu)
  • Pituitary apoplexy (PA) most commonly manifests as a spontaneous hemorrhage or infarct of a pituitary adenoma and can present with visual and endocrine defects. (cns.org)
  • Pituitary apoplexy occurs when a pituitary adenoma either spontaneously hemorrhages or grows in such a way as to compress and cut off its own blood supply, resulting in tumor cell death, bleeding, and acute swelling . (symptoma.com)
  • In this report, we present a 42-year-old man who had been diagnosed of pituitary adenoma presented with a sudden onset of unconsciousness , left hemiplegia and right ptosis. (symptoma.com)
  • Isolated postoperative hyponatremia resistant to medical correction consider a central cause, in particular pituitary adenoma and/or apoplexy. (medscape.com)
  • Rarely, the pituitary tumor apoplexy may be induced by the administration of a hypothalamic-releasing hormone (e.g., gonadotropin-releasing hormone agonist in a patient with a gonadotropin-secreting adenoma) or by the administration of an agent used to treat the pituitary tumor (e.g., bromocriptine for a prolactin-secreting pituitary tumor). (pediagenosis.com)
  • Pituitary imaging with magnetic resonance imaging (MRI) is diagnostic and typically shows signs of intra-pituitary or intra-adenoma hemorrhage, fluid-fluid level, and compression of normal pituitary tissue. (pediagenosis.com)
  • Imaging revealed a 2.1 (anterior-posterior) × 2.2 (transverse) × 1.3 (craniocaudal) cm pituitary adenoma invading into the left cavernous sinus and encasing the left internal carotid artery. (bvsalud.org)
  • Hong C, Alanya H, DiStasio M, Boulware S, Rimmer R, Omay S , Erson-Omay E. Sporadic pituitary adenoma with somatic double-hit loss of MEN1. (yalemedicine.org)
  • She had a history of a pituitary adenoma 30 years previously, treated by open craniotomy and post-operative radiotherapy. (drtimothysteel.com.au)
  • The differential diagnosis was an ONSM, a diffuse glioma of the optic nerve, or less likely, an atypical recurrence of pituitary adenoma. (drtimothysteel.com.au)
Adenomas11
  • Mohr and Hardy reviewed hospital records of 664 patients who had surgery for pituitary adenomas. (medscape.com)
  • When apoplexy occurs in functioning adenomas, it may cause spontaneous remission. (nel.edu)
  • The incidence of pituitary apoplexy ranges from 1 to 20% in surgically verified pituitary adenomas, with a slight male predominance. (symptoma.com)
  • It should be noted that necrosis and hemorrhage within a pituitary tumor occur much more frequently than the clinical syndrome of pituitary apoplexy, especially in silent corticotroph adenomas, in which hemorrhage occurs in more than 50% of the tumors. (pediagenosis.com)
  • This is despite the high prevalence of occult pituitary adenomas in the general population, the widespread use of high definition imaging techniques, and the broad range of intra- and perisellar lesions that can mimic pituitary adenomas. (bmj.com)
  • Inappropriate pituitary hormone secretion and visual field deficits are the most characteristic presenting features of pituitary adenomas. (bmj.com)
  • Pituitary adenomas are classified by size and hormone secretory subtype. (bmj.com)
  • Clinically silent double pituitary adenomas consisting of corticotroph and somatotroph cells are an exceedingly rare clinical finding. (bvsalud.org)
  • Determining the K i -67 index of silent pituitary adenomas could be valuable in predicting recurrence after initial surgical resection and identifying tumors that are at an increased risk of needing additional therapeutic interventions or more frequent surveillance imaging. (bvsalud.org)
  • Pituitary adenomas frequently invade the cavernous sinus. (go.jp)
  • The oblique transsphenoethmoidal approach, a modified standard transsphenoidal approach, was used to treat 19 patients with pituitary adenomas invading the cavernous sinus. (go.jp)
Tumor apoplexy2
  • Pituitary tumor apoplexy: a review. (medscape.com)
  • A conservative management is preferable in milder forms of pituitary tumor apoplexy. (cns.org)
Hemorrhage11
  • Pituitary apoplexy is characterized by a sudden onset of headache, visual symptoms, altered mental status, and hormonal dysfunction due to acute hemorrhage or infarction of a pituitary gland. (medscape.com)
  • Frequency of intratumoral hemorrhage increases to 26% if using only MRI criteria without clinical evidence of apoplexy. (medscape.com)
  • Kurisu et al described a 68-year-old man who developed pituitary apoplexy resulting in massive intracerebral hemorrhage and death 1 month later. (medscape.com)
  • Pituitary apoplexy describes a condition in which the pituitary gland is subject to necrotic changes that may or may not be due to hemorrhage . (symptoma.com)
  • This is generally the result of sudden hemorrhage and necrosis in the lateral pituitary fossa, leading to the displacement of the oculomotor nerves. (symptoma.com)
  • NCI Thesaurus A rare, potentially life-threatening disorder caused by acute ischemic infarction or hemorrhage in the pituitary gland. (symptoma.com)
  • Kumar V, Kataria R, Mehta VS. Dengue hemorrhagic fever: A rare cause of pituitary tumor hemorrhage and reversible vision loss. (medscape.com)
  • Although pituitary apoplexy, acute hemorrhage of the pituitary gland, is an uncommon event, it is an endocrine emergency, and prompt diagnosis and treatment are critical. (pediagenosis.com)
  • This may be a potential source of confusion in differentiating pituitary apoplexy from meningitis or subarachnoid hemorrhage. (pediagenosis.com)
  • Pituitary apoplexy occurs most often in the setting of a preexisting pituitary macroadenoma or cyst, and the hemorrhage may be spontaneous or triggered by head trauma, coagulation disorders (e.g., idiopathic thrombocytopenic purpura), or anticoagulant (e.g., heparin, warfarin) administration. (pediagenosis.com)
  • MRI revealed a mass on the right side of the pituitary gland, with evidence of likely hemorrhage on the left. (bvsalud.org)
Gland17
Posterior pituitary3
  • This may be caused by low cortisol levels or by inappropriate release of antidiuretic hormone (ADH) from the posterior pituitary. (wikipedia.org)
  • Because of the anatomy of the pituitary circulation and the sparing of the infundibular circulation (inferior hypophysial arteries), the posterior pituitary is infrequently affected by pituitary apoplexy. (pediagenosis.com)
  • Hormones secreted by neurohypophysis (posterior pituitary). (medscape.com)
Tumors4
  • It was previously thought that particular types of pituitary tumors were more prone to apoplexy than others, but this has not been confirmed. (wikipedia.org)
  • In absolute terms, only a very small proportion of pituitary tumors eventually undergoes apoplexy. (wikipedia.org)
  • This explanation is doubtful, since most tumors that undergo apoplexy are slow growing. (medscape.com)
  • The labia are then prone to spontaneous remissions and exacerbations that vary from virtually every minute of the hip and tumors. (surgicalimpex.com)
Cavernous3
  • Adjacent to the pituitary lies a part of the skull base known as the cavernous sinus. (wikipedia.org)
  • Pituitary apoplexy resulting in internal carotid artery occlusion has been reported due to the mass compressing the bilateral cavernous sinuses, resulting in obliteration of the cavernous portion of the right internal carotid artery. (medscape.com)
  • The lateral aspects of the pituitary are adjacent to the cavernous sinuses (see the image below). (medscape.com)
Ischemic3
  • [ 1 ] It is important to note that pituitary apoplexy may be divided into hemorrhagic or ischemic, each with unique neuroimaging findings, and some patients have elements of both. (medscape.com)
  • Enhanced T1-weighted axial and coronal MRI showing a large pituitary tumor that has recently undergone ischemic apoplexy showing a necrotic (hypointense) center and ring of gadolinium enhancement (hyperintense), ie, the "pituitary ring sign. (medscape.com)
  • Pituitary metastasis presenting as ischemic pituitary apoplexy following heparin-induced thrombocytopenia. (medscape.com)
Endocrine3
  • With the possible equally obtainable visual and endocrine improvements in both surgical and conservative treatment of pituitary apoplexy, physicians and patients can be open to discussing both invasive and non-invasive forms of symptom management. (cns.org)
  • Okuda O, Umezawa H, Miyaoka M. Pituitary apoplexy caused by endocrine stimulation tests: a case report. (medscape.com)
  • Less specific symptoms such as headache, and subtle signs of pituitary hormone deficiency with peripheral endocrine organ hypofunction characterised by amenorrhoea, loss of libido, and lethargy, are also common. (bmj.com)
Hemorrhagic4
Symptoms3
  • By the conclusion of this session, participants should be able to 1) Describe the various possible presenting symptoms of pituitary apoplexy, 2) Discuss, in small groups, pros and cons of surgery versus conservative management in light of the presenting results, and 3) Identify an effective approach towards a case-by-case treatment decision. (cns.org)
  • Fatigue Seizures Pituitary Apoplexy: Diagnosis Your doctor will conduct a thorough physical exam and ask you about your symptoms and medical history. (symptoma.com)
  • Symptoms and signs of pituitary hormone deficiency are more subtle than those seen in primary end organ failure (table 1). (bmj.com)
Intracranial1
Symptomatic2
  • After treatment with ventilator assisted breathing, hormone therapy, neurotrophic and anti-infection therapies, and symptomatic and supportive care for more than three months, spontaneous breathing was restored. (nel.edu)
  • That spontaneous hyperinsulinism might be a cause of symptomatic hypoglycemia was first proposed by Seale Harris , MD, 1924, in Journal of the American Medical Association . (ipfs.io)
Subarachnoid space1
  • The superior aspect of the pituitary is covered by the diaphragma sellae, which is a fold of dura mater that separates the cerebrospinal fluid-filled subarachnoid space from the pituitary. (medscape.com)
Stalk3
  • Some postulate that a gradually enlarging pituitary tumor becomes impacted at the diaphragmatic notch, compressing and distorting the hypophyseal stalk and its vascular supply. (medscape.com)
  • These hypothalamic cell bodies produce hormones that undergo axonal transport through the pituitary stalk and into terminal axons within the neurohypophysis. (medscape.com)
  • The patient they would result in severe eruptions, eg pituitary stalk section, explain how the affected in combination of perianal skin. (solepost.com)
Macroadenoma1
Prolactinomas1
  • Pituitary tumour apoplexy within prolactinomas in children? (cns.org)
Optic1
  • Humphrey computerised visual fields are useful even if there appears to be no contact between the optic pathways and pituitary mass. (bmj.com)
Occurs2
Commonly1
  • Pituitary apoplexy has a variable presentation , although it most commonly presents with headaches , visual changes , changes in consciousness and ophthalmoplegia . (symptoma.com)
Lesions1
  • In this brief overview, the presentation, classification, and general investigation of pituitary lesions is followed by a discussion of the diagnosis and management of specific secretory subtypes. (bmj.com)
Gadolinium1
  • Gadolinium enhancement of pituitary MRI can be helpful for small microadenomas. (bmj.com)
Computed tomography1
  • Association of degenerative change in pituitary ademona with radiotherapy and detection by cerebral computed tomography. (medscape.com)
Syndrome2
  • Pituitary apoplexy is a rare clinical syndrome associated with rapid enlargement of a pituitary mass. (nel.edu)
  • Kaplun J, Fratila C, Ferenczi A, Yang WC, Lantos G, Fleckman AM. Sequential pituitary MR imaging in Sheehan syndrome: report of 2 cases. (medscape.com)
Hormonal1
  • Hormonal evaluation typically shows complete anterior pituitary failure (including prolactin). (pediagenosis.com)
Sudden1
  • The word apoplexy is defined as a sudden neurologic impairment, usually due to a vascular process. (medscape.com)
Rarely1
  • Pituitary apoplexy is rarely associated with subarachnoid bleed and vasospasm, leading to cerebral infarcts and consequent focal neurologic deficits. (medscape.com)
Diagnosis1
  • The diagnosis of pituitary disease is generally uncomplicated. (bmj.com)
PRESENTATION3
  • We report the initial presentation, subsequent course and outcome of an acromegalic patient who developed spontaneous remission following pituitary apoplexy with pathologic findings of tumor infarction. (nel.edu)
  • Presentation , management and outcomes in acute pituitary apoplexy? (cns.org)
  • In more than 50% of cases of pituitary apoplexy, the apoplectic event is the initial clinical presentation of a pituitary tumor. (pediagenosis.com)
Hormone3
  • Many people who have had a pituitary apoplexy develop pituitary hormone deficiencies and require long-term hormone supplementation. (wikipedia.org)
  • Follow up and optimisation of pituitary hormone replacement is also relatively straightforward, but management of visual impairment, reduced fertility, coarsened facial features, arthritis, obesity, headaches, and obstructive sleep apnoea is often much more troublesome. (bmj.com)
  • Syndromes of pituitary hormone excess are described below. (bmj.com)
Diabetes3
  • Spontaneous remission of acromegaly after infarctive apoplexy with a possible relation to MRI and diabetes mellitus. (nel.edu)
  • Cinar N, Metin Y, Dagdelen S, Ziyal M, Soylemezoglu F, Erbas T. Spontaneous remission of acromegaly after infarctive apoplexy with a possible relation to MRI and diabetes mellitus. (nel.edu)
  • Thus, diabetes insipidus is rare in patients with pituitary apoplexy. (pediagenosis.com)
Coronal1
  • Magnetic resonance imaging (MRI) scanning of the pituitary region, involving fine cuts and saggital and coronal reconstruction, is the gold standard imaging method for pituitary disease. (bmj.com)
Anterior2
  • Hormones secreted by adenohypophysis (anterior pituitary). (medscape.com)
  • The sella turcica is a saddle-shaped depression that surrounds the inferior, anterior, and posterior aspects of the pituitary. (medscape.com)
Compression1
Patients4
  • Various precipitating factors have been reported in 25-30% of pituitary apoplexy patients. (nel.edu)
  • Erythrocytes and an increased protein concentration are found in the cerebrospinal fluid of many patients with pituitary apoplexy. (pediagenosis.com)
  • Stress dosages of glucocorticoids should be initiated in all patients with pituitary apoplexy. (pediagenosis.com)
  • The Pituitary Foundation (internet search term: "Pit Pat") provides important opinion and information, and reassures patients that they are not alone. (bmj.com)
Cerebrospinal1
  • Lymphocytic hypophysitis, pituitary apoplexy, and evidence of more extensive disease such as cranial nerve palsies, temporal lobe epilepsy, hydrocephalus, and cerebrospinal fluid (CSF) rhinorrhoea are fortunately rarer. (bmj.com)
Confusion1
Frequency1
Hormones2
  • The adenohypophysis constitutes roughly 80% of the pituitary and manufactures an array of peptide hormones. (medscape.com)
  • The release of these pituitary hormones is mediated by hypothalamic neurohormones that are secreted from the median eminence (a site where axon terminals emanate from the hypothalamus) and that reach the adenohypophysis via a portal venous system. (medscape.com)
Investigations1
Cases1
  • Introduction We present two cases of suspected pituitary apoplexy found instead to be infarcted pituitary glands without histopathologic evidence of neoplastic cells, likely resulting from spontaneous infarction of previously healthy pituitary glands. (bvsalud.org)
Aggressive1
  • In addition to the ectopic location, this pituitary tumor was noted to be aggressive in nature based on its high K i -67 index. (bvsalud.org)
Outcome1
  • 2. Giritharan S, Gnanalingham K, Kearney T. Pituitary apoplexy - bespoke patient management allows good clinical outcome. (cns.org)
Patient2
  • Although the timing of the surgical intervention does not seem to affect the recovery of ocular palsies, an operation within 1 week after apoplexy in a conscious patient whose condition is stable improves recovery of visual acuity more than an operation performed with a delay of more than 1 week after the event. (pediagenosis.com)
  • Therefore, waiting for spontaneous resolution of a visual field defect in a patient whose condition is otherwise stable may not be optimal management. (pediagenosis.com)
Defects1
  • An exaggerated "physiological" trophic response to prolonged hypothyroidism presenting with visual field defects is well described but is, like pituitary carcinoma, very rare. (bmj.com)
Condition1
  • Pituitary apoplexy can be a life-threatening condition, and it is not easily diagnosed or treated. (medscape.com)
Rare1