Pituitary apoplexy

Abstract

Pituitary apoplexy (PA) is a rare clinical syndrome caused by sudden hemorrhaging and/or infarction of the pituitary gland, generally within a pituitary adenoma. The main symptom is sudden-onset severe headache, associated with visual disorders or ocular palsy. Corticotropic deficiency may be life-threatening if left untreated. Computed tomography (CT) or MRI confirms the diagnosis by revealing a pituitary tumor with hemorrhagic and/or necrotic components. PA used to be considered a neurosurgical emergency but a conservative approach is increasingly used in selected patients, as it yields similar outcomes. Glucocorticoid treatment must always be started immediately after onset.

Keywords: Corticotropic deficiency; Emergency; Hemorrhage; Magnetic resonance imaging; Necrosis; Neurosurgery; Pituitary adenoma; Pituitary apoplexy.