1,569 results match your criteria Pituitary Apoplexy


Pituitary apoplexy in an adolescent male with macroprolactinoma presenting as middle cerebral artery territory infarction.

Ann Pediatr Endocrinol Metab 2022 May 16. Epub 2022 May 16.

Department of Paediatric Endocrinology, Variety Children Hospital, King's College Hospital NHS Foundation Trust, London, UK.

Pituitary apoplexy typically presents with acute headache, vomiting, visual disturbance and confusion. We report a rare presentation of ischaemic stroke due to pituitary apoplexy. A 16. Read More

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Pituitary Apoplexy in Pregnancy.

J Obstet Gynaecol Can 2021 Jun 29. Epub 2021 Jun 29.

Department of Obstetrics and Gynaecology, National University Hospital, Singapore.

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Suppression of pituitary hormone genes in subjects who died from COVID-19 independently of virus detection in the gland.

J Clin Endocrinol Metab 2022 May 14. Epub 2022 May 14.

Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy.

Context: Involvement of the pituitary gland in SARS-CoV-2 infection has been clinically suggested by pituitary hormone deficiency in severe COVID-19 cases, by altered serum ACTH levels in hospitalized patients, and by cases of pituitary apoplexy. However, the direct viral infection of the gland has not been investigated.

Objectives: To evaluate whether the SARS-CoV-2 genome and antigens could be present in pituitary glands of lethal cases of COVID-19, and to assess possible changes in the expression of immune-related and pituitary-specific genes. Read More

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Pituitary Apoplexy Precipitated by Systemic Chemotherapy.

Cureus 2022 Mar 9;14(3):e23004. Epub 2022 Mar 9.

Neurosurgery, University of Utah, Salt Lake City, USA.

Pituitary apoplexy often occurs in patients with previously undiagnosed pituitary adenomas and no predisposing factors. Among patients with precipitating events, there are very few cases of pituitary apoplexy occurring in the setting of systemic chemotherapy treatment. A 31-year-old man with newly diagnosed metastatic testicular cancer developed headaches, nausea, and a right-sided visual field deficit one week after initiation of bleomycin, etoposide, and cisplatin chemotherapy. Read More

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Pituitary apoplexy: An emergent and potential life-threatening complication of pituitary adenomas.

Ulus Travma Acil Cerrahi Derg 2022 Apr;28(4):483-489

Department of Neurosurgery, Gaziantep University Faculty of Medicine, Gaziantep-Turkey.

Background: Pituitary apoplexy is an emergent and potential life-threatening complication of pituitary adenomas if not managed properly. The aim of our study is to present our series of pituitary adenomas and to focus on the clinical, radiological, and surgical characteristics of this rare complication.

Methods: In this study, a total of 143 patients with pituitary adenoma underwent surgical treatment between 2016 and 2018. Read More

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Pituitary apoplexy following adenoviral vector-based COVID-19 vaccination.

Brain Hemorrhages 2022 Apr 19. Epub 2022 Apr 19.

Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplantation, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy.

Pituitary apoplexy (PA) may complicate the course of coronavirus disease 2019 (COVID-19), posing a potential threat to life. Among vaccines designed to prevent COVID-19, there are those adenoviral vector-based, such as Vaxzevria® (formerly COVID-19 Vaccine AstraZeneca). The product insert states that it can cause very rare coagulation disorders, in particular thrombosis with thrombocytopenia syndrome in some cases accompanied by bleeding, cerebrovascular venous or sinus thrombosis, and thrombocytopenia, including immune thrombocytopenia, also associated with bleeding. Read More

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Suspected Pituitary Apoplexy: Clinical Presentation, Diagnostic Imaging Findings and Outcome in 19 Dogs.

Vet Sci 2022 Apr 15;9(4). Epub 2022 Apr 15.

Neurology and Neurosurgery Division, San Marco Veterinary Clinic, 35030 Veggiano, Italy.

In human medicine, pituitary apoplexy (PA) is a clinical syndrome characterised by the sudden onset of neurological signs because of haemorrhage or infarction occurring within a normal or tumoral pituitary gland. The diagnosis is usually performed combining neurological signs and imaging findings. The aim of the present study is to describe the abnormal neurological signs, the diagnostic imaging findings, based on Computed Tomography (CT) and/or Magnetic Resonance Imaging (MRI), and the outcome in a population of dogs with suspected PA. Read More

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Association between socioeconomic status and presenting characteristics and extent of disease in patients with surgically resected nonfunctioning pituitary adenoma.

J Neurosurg 2022 Apr 8:1-8. Epub 2022 Apr 8.

1Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California.

Objective: The aim of this study was to evaluate the association between zip code-level socioeconomic status (SES) and presenting characteristics and short-term clinical outcomes in patients with nonfunctioning pituitary adenoma (NFPA).

Methods: A retrospective review of prospectively collected data from the University of Southern California Pituitary Center was conducted to identify all patients undergoing surgery for pituitary adenoma (PA) from 2000 to 2021 and included all patients with NFPA with recorded zip codes at the time of surgery. A normalized socioeconomic metric by zip code was then constructed using data from the American Community Survey estimates, which was categorized into tertiles. Read More

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Clinical Features of Craniopharyngioma With Tumoral Hemorrhage: A Retrospective Case-Controlled Study.

Front Surg 2022 14;9:845273. Epub 2022 Mar 14.

Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Background: Craniopharyngioma (CP) with tumoral hemorrhage is a very rare syndrome presenting with various manifestation and unfavorable outcomes. The current retrospective study was performed to summarize the clinical features of CP with tumoral hemorrhage.

Methods: In this study, 185 patients with pathological diagnosis of CP (18 patients with hemorrhage) were enrolled. Read More

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Isolated Unilateral Abducens Nerve Palsy Manifesting as a Rare Complication of Idiopathic Pituitary Apoplexy: A Case Report.

Cureus 2022 Feb 20;14(2):e22408. Epub 2022 Feb 20.

Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, USA.

Pituitary apoplexy (PA) is an expansion of a pituitary adenoma due to infarction or hemorrhage of the gland. The term apoplexy usually describes larger bleeds leading to a sudden onset of symptoms. Although it is a rare condition, it can be a life-threatening emergency. Read More

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February 2022

Bilateral antererior circulation stroke: A rare but threatening consequence of pituitary apoplexy. Case report and systematic literature review.

Neuroradiol J 2022 Mar 27:19714009221083146. Epub 2022 Mar 27.

Programma Neurochirurgia Ipofisi- Pituitary Unit, 419170IRCCS Istituto delle Scienze Neurologiche di Bologna, Italy.

Background: Brain stroke is a rare, life-threatening condition associated with pituitary apoplexy (PA), resulting from direct arterial occlusion due to mechanical compression secondary to the sudden enlargement of the pituitary adenoma, or to vessel vasospasm, induced by tumor hemorrhage.

Case Report: We report the case of a 64-year-old woman with PA complicated by bilateral anterior circulation stroke due to critical stenosis of both anterior cerebral arteries (ACA). Despite the quick surgical decompression and consequent blood flow restoration, the neurological conditions of the patient did not improve and she died 18 days later. Read More

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Neurological Presentation of Giant Pituitary Tumour Apoplexy: Case Report and Literature Review of a Rare but Life-Threatening Condition.

J Clin Med 2022 Mar 13;11(6). Epub 2022 Mar 13.

IRCCS Centro Neurolesi "Bonino-Pulejo", Via Provinciale Palermo, Contrada Casazza, 98124 Messina, Italy.

Background: Giant pituitary adenomas are benign intracranial tumours with a diameter ≥4 cm. Even if hormonally non-functional, they may still cause local extension, leading to symptoms that include mostly gland dysfunction, mass effects, and, much less frequently, apoplexy due to haemorrhage or infarction. Neurological presentation of giant pituitary tumour apoplexy is even more rare and has not been systematically reviewed. Read More

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Pituitary apoplexy and COVID-19 vaccination.

Med Clin (Barc) 2022 Jan 31. Epub 2022 Jan 31.

Honorary Professor, Dr. DY Patil University, Pune, India.

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January 2022

Late onset of pituitary apoplexy following gonadotropin-releasing hormone agonist for prostate cancer treatment.

BMJ Case Rep 2022 Mar 7;15(3). Epub 2022 Mar 7.

Endocrinology, Diabetes and Metabolism, The University of Arizona College of Medicine Phoenix, Phoenix, Arizona, USA.

Pituitary apoplexy (PA) is a clinical condition characterised by a sudden increase in pituitary gland volume secondary to ischaemia and/or necrosis. Most cases occur in non-functioning pituitary adenoma but can also occur in functioning adenoma. Certain predisposing factors can result in PA and the use of gonadotropin-releasing hormone (GnRH) agonists for prostate cancer (PCa) is one such condition. Read More

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Pituitary Gland Surgical Emergencies: The Role of Endoscopic Intervention.

Otolaryngol Clin North Am 2022 Apr 4;55(2):397-410. Epub 2022 Mar 4.

Department of Otolaryngology-Head and Neck Surgery, Emory Sinus, Nasal and Allergy Center, Emory University School of Medicine, 550 Peachtree Street Northeast, MOT 11th Floor, Atlanta, GA 30308, USA. Electronic address:

True pituitary surgical emergencies are rare. These events can occur throughout the perioperative period and are broadly categorized by the timing of occurrence. Acute indications for emergent pituitary surgery include pituitary apoplexy, vision loss, and severe Cushing presentation. Read More

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Endocrine Follow-up During Post-Acute COVID-19: Practical Recommendations Based on Available Clinical Evidence.

Endocr Pract 2022 Apr 11;28(4):425-432. Epub 2022 Feb 11.

Department of Endocrinology, Institute of Postgraduate Medical Education and Research, Kolkata, India.

Objective: COVID-19 affects multiple endocrine organ systems during the disease course. However, follow-up data post-COVID-19 is scarce; hitherto available limited data suggest that most of the biochemical endocrine dysfunctions observed during acute phase of COVID-19 tend to improve after recovery. Hence, we aim to provide a rational approach toward endocrine follow-up of patients during post-acute COVID-19. Read More

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Ischemic Infarction of Pituitary Apoplexy: A Retrospective Study of 46 Cases From a Single Tertiary Center.

Front Neurosci 2021 24;15:808111. Epub 2022 Jan 24.

Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Objective: Ischemic infarction of pituitary apoplexy (PA) is a rare type of pituitary apoplexy. This study aims to characterize ischemic PA via clinical presentations, imaging data, histopathological manifestations, and focus on the management and prognosis of the disease.

Methods: This study retrospectively identified 46 patients with ischemic PA confirmed using histopathology at a single institution from January 2013 to December 2020. Read More

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January 2022

Application of fusion-fluorescence imaging using indocyanine green in endoscopic endonasal surgery.

J Clin Neurosci 2022 Apr 4;98:45-52. Epub 2022 Feb 4.

Department of Neurosurgery, Uijeongbu St. Mary's Hospital, the Catholic University of Korea, Seoul, Republic of Korea. Electronic address:

Objective: Indocyanine green (ICG) has been used in endoscopic surgery in the neurosurgical field, but it has been challenging to determine the associated efficiency due to limitations with visualization in the previous endoscopic system. A new endoscopic system was recently introduced; therefore, we summarize our experiences with the application and integration of the system.

Methods: From March to June 2021, a newly introduced endoscopic system was used in 10 patients. Read More

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Pituitary adenoma apoplexy in pregnancy: Case report and literature review.

Exp Ther Med 2022 Mar 14;23(3):218. Epub 2022 Jan 14.

Department of Obstetrics and Gynecology, National Institute of Mother and Child Care, 400012 Bucharest, Romania.

Gestational pituitary apoplexy is an extremely rare condition. It is characterised by an unexpected headache, vomiting, nausea, and visual disturbances. Pituitary apoplexy in pregnancy and postpartum is a challenging diagnosis with symptoms overlapping multiple conditions. Read More

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Development of a Carotid Cavernous Aneurysm after Medical Treatment of a Prolactinoma: A Case Report.

NMC Case Rep J 2021 23;8(1):733-738. Epub 2021 Oct 23.

Ebisu Neuro-Surgical Clinic, Tokyo, Japan.

This is the first report of a carotid aneurysm that developed from a cavernous carotid artery contiguous with a prolactinoma during medical treatment of the prolactinoma, which gradually grew larger while the tumor regressed. A 78-year-old woman presented with headache and neurological symptoms indicating the involvement of cranial nerves in the cavernous sinus. Gadolinium-enhanced T1-weighted magnetic resonance imaging on admission revealed an abnormal right cavernous sinus, with an approximately 17 mm mass extending into the right cavernous portion of the internal carotid artery, and was contiguous with the intracavernous carotid artery. Read More

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October 2021

Pituitary Apoplexy Following Severe Diabetic Ketoacidosis, with Two Uncommon Complications of Supraventricular Tachycardia and Acute Limb Ischemia, in a Patient with Neglected Pituitary Adenoma and Undiagnosed Diabetes Mellitus: A Rare Clinical Association.

Asian J Neurosurg 2021 Oct-Dec;16(4):890-894. Epub 2021 Dec 18.

Department of Neurosurgery, P. D. Hinduja National Hospital and MRC, Mumbai, Maharashtra, India.

Pituitary apoplexy (PA) is a clinical emergency arising from acute ischemia or hemorrhage of the pituitary gland. A small subset of pituitary adenomas present with an apoplectic crisis, with common symptoms being headache, nausea-vomiting, visual impairment, ophthalmoplegia, altered sensorium, and panhypopituitarism. Though diabetic ketoacidosis (DKA) is an established complication of uncontrolled diabetes mellitus, its association with PA is extremely rare. Read More

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December 2021

Towards a pituitary apoplexy classification based on clinical presentation and patient journey.

Endocrine 2022 04 24;76(1):132-141. Epub 2022 Jan 24.

Dept. of Medicine, Division of Endocrinology, and Centre for Endocrine Tumors Leiden, Leiden University Medical Center, Leiden, the Netherlands.

Purpose: The condition of pituitary apoplexia contains the clinical spectre from life-threatening emergency to asymptomatic self-limiting course, which partly determines diagnostic delay and management. Outcome evaluation of course and management of pituitary apoplexia is hampered by the diverse presentation of this condition and requires appraisal. This study aimed to describe the patient journey, clinical presentation, and management of various types of pituitary apoplexy in a new classification to facilitate future outcome evaluation and identify unmet needs in the care process. Read More

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Editorial "pituitary apoplexy-are visual deficits the only indication for emergent surgical intervention?"

Acta Neurochir (Wien) 2022 Apr 24;164(4):1125-1126. Epub 2022 Jan 24.

Department of Neurosurgery, Saarland University Medical Centre, Kirrbergerstraße, Building 90.5, 66421, Homburg, Germany.

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Covid-19, the thyroid and the pituitary - The real state of play.

Ann Endocrinol (Paris) 2022 Apr 20;83(2):103-108. Epub 2022 Jan 20.

Service d'endocrinologie, maladies métaboliques et nutrition, pôle cardio-vasculaire et métabolique, CHU Larrey, 24, chemin de Pouvourville, TSA 30030, 31059 Toulouse cedex, France.

Thyroid and pituitary disorders linked to the coronavirus SARS-CoV-2, responsible for the COVID-19 epidemic, are mainly due to direct infection of the endocrine glands by the virus and to cell damage induced by the immune response. The two most frequent thyroid complications of COVID-19 are low T3 syndrome, or "non-thyroidal illness syndrome" (NTIS), and thyroiditis. Studies among in-patients with COVID-19 have shown that between one out of six and half of them have a low TSH level, related to NTIS and thyroiditis, respectively, sometimes found in the same patient. Read More

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Outcomes and surgical nuances in management of giant pituitary adenomas: a review of 108 cases in the endoscopic era.

J Neurosurg 2022 Jan 21:1-12. Epub 2022 Jan 21.

1Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah.

Objective: Giant (maximum diameter ≥ 4 cm) pituitary macroadenomas are complex tumors that require resection for decompression of optic nerves, relief of mass effect, and symptom improvement. Given the lack of surgical accessibility, the lateral extent of the lesions, and the invasion of the cavernous sinus, management presents a significant challenge. Transsphenoidal, transcranial, and combined approaches have been viable options for resection. Read More

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January 2022

Long-term oncological outcomes after haemorrhagic apoplexy in pituitary adenoma managed operatively and non-operatively.

Acta Neurochir (Wien) 2022 Apr 18;164(4):1115-1123. Epub 2022 Jan 18.

Geoffrey Jefferson Brain Research Centre, University of Manchester, Manchester, UK.

Introduction: Depending on severity of presentation, pituitary apoplexy can be managed with acute surgery or non-operatively. We aim to assess long-term tumour control, visual and endocrinological outcomes following pituitary apoplexy with special emphasis on patients treated non-operatively.

Methods: Multicentre retrospective cohort study. Read More

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Distant Pituitary Adenoma Spread: A Systematic Review and Report of 2 Cases.

Oper Neurosurg (Hagerstown) 2022 03;22(3):131-143

Department of Neurological Surgery, University of Texas Southwestern Medical Center, Zale Lipshy Hospital, Dallas, Texas, USA.

Background: Distant spread of pituitary adenoma outside the sellar/suprasellar region is classified as pituitary carcinoma. Cerebrospinal fluid (CSF)-born spread of pituitary adenoma can occur after tumor cell spillage into the CSF space after surgery, irradiation, or apoplexy and is not necessarily related to intrinsic tumor biology.

Objective: To systematically review the literature and describe the clinical characteristics and treatment strategies of patients with pituitary carcinomas. Read More

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Rapidly Progressive Pituitary Apoplexy in a Patient with COVID-19 Disease Treated with Endoscopic Endonasal Surgery.

J Neurol Surg Rep 2022 Jan 10;83(1):e8-e12. Epub 2022 Jan 10.

Division of Endocrinology and Metabolism, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States.

This report describes a case of pituitary apoplexy with rapidly evolving hemorrhage in a 74-year-old female with coronavirus disease 2019 (COVID-19) disease. The patient presented with severe headache and mild respiratory symptoms, with laboratories concerning for pituitary hypofunction. Brain imaging demonstrated a sellar mass concerning for a pituitary adenoma with ischemic apoplexy. Read More

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January 2022

Pituitary Apoplexy in Geriatric Patients: A Report of Four Cases.

Cureus 2021 Dec 10;13(12):e20318. Epub 2021 Dec 10.

Department of Endocrinology, Diabetology, Nutrition, and Metabolic Diseases, Shaikh Khalifa Bin Zayed Al-Nahyan Hospital - Mohammed VI University of Health Sciences, Casablanca, MAR.

Pituitary apoplexy (PA) is a rare clinical syndrome related to abrupt hemorrhage and/or infarction of the pituitary gland, usually occurring in patients with preexisting pituitary disease. It is an endocrine emergency requiring rapid diagnosis and appropriate management. This is a literature review and a retrospective study reporting the observation of four patients that have suffered from pituitary macroadenomas. Read More

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December 2021