1,471 results match your criteria Pituitary Apoplexy


Silent corticotroph pituitary adenomas: clinical characteristics, long-term outcomes, and management of disease recurrence.

J Neurosurg 2021 May 7:1-8. Epub 2021 May 7.

Departments of1Neurological Surgery.

Objective: Silent corticotroph adenomas (SCAs) are a distinct subtype of nonfunctioning pituitary adenomas (NFAs) that demonstrate positive immunohistochemistry for adrenocorticotropic hormone (ACTH) without causing Cushing's disease. SCAs are hypothesized to exhibit more aggressive behavior than standard NFAs. The authors analyzed their institution's surgical experience with SCAs in an effort to characterize rates of invasion, postoperative clinical outcomes, and patterns of disease recurrence and progression. Read More

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Rapid resolution of a third nerve palsy from pituitary apoplexy.

BMJ Case Rep 2021 May 6;14(5). Epub 2021 May 6.

Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada

A 49-year-old man presented with new onset headache and diplopia, with right ptosis and limitation of extraocular movements consistent with a third nerve palsy. He had a known diagnosis of a non-functioning pituitary adenoma, and his presentation and neuroimaging were consistent with ischaemic pituitary apoplexy. The patient was otherwise stable with no signs of optic neuropathy or endocrine abnormality. Read More

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COVID-19 and the pituitary.

Pituitary 2021 May 3. Epub 2021 May 3.

Institute of Endocrine and Metabolic Sciences, San Raffaele Vita-Salute University and IRCC Hospital, Via Olgettina 60, 20132, Milan, Italy.

Background: Despite COVID-19 being identified as severe respiratory viral infection, progressively many relevant endocrine manifestations have been reported greatly contributing to the severity of the clinical presentation. Systemic involvement in COVID-19 is due to the ubiquitous expression of angiotensin-converting enzyme 2 (ACE2) receptor, responsible for the entry in the cells of SARS-CoV-2, Several reports in humans and animal models showed a significant ACE2 mRNA expression in hypothalamus and pituitary cells. Moreover, higher mortality and poorer outcomes have been widely described in COVID-19 patients with obesity, diabetes and vertebral fractures, which are all highly prevalent in subjects with pituitary dysfunctions. Read More

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Pituitary Apoplexy: A Retrospective Study of 33 Cases From a Single Center.

Front Endocrinol (Lausanne) 2021 15;12:656950. Epub 2021 Apr 15.

Department of Endocrinology, Karolinska University Hospital, Stockholm, Sweden.

Purpose: Acute symptomatic pituitary apoplexy is a rare and potentially life-threatening condition. However, pituitary apoplexy can also present with milder symptoms and stable hemodynamics. Due to the rarity of this inhomogeneous condition, clinical studies are important to increase the knowledge. Read More

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Apoplexy of Crooke cell tumour leading to the diagnosis of severe Cushing disease; a case report.

BMC Endocr Disord 2021 May 1;21(1):93. Epub 2021 May 1.

Neurosurgical Unit, National Hospital of Sri Lanka, Colombo 10, Sri Lanka.

Background: Patients with Crooke cell tumours present with features of Cushing syndrome or mass effect. There are few reports of patients with Crooke cell tumours presenting due to apoplexy. All of them had silent tumours. Read More

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Radiological and clinical outcomes of pituitary apoplexy: comparison of conservative management versus early surgical intervention.

J Neurosurg 2021 Apr 30:1-9. Epub 2021 Apr 30.

1Department of Neurosurgery, University of Virginia Health System, Charlottesville, Virginia.

Objective: Early surgical intervention for patients with pituitary apoplexy (PA) is thought to improve visual outcomes and decrease mortality. However, some patients may have good clinical outcomes without surgery. The authors sought to compare the radiological and clinical outcomes of patients with PA who were managed conservatively versus those who underwent early surgery. Read More

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Apoplexy of microprolactinomas during pregnancy.

Eur J Endocrinol 2021 Apr 1. Epub 2021 Apr 1.

P Chanson, Service d'Endocrinologie et des Maladies de la Reproduction, Centre de Référence des Maladies Rares de l'Hypophyse, Assistance Publique - Hopitaux de Paris, Le Kremlin-Bicêtre, France.

Context: Prolactinomas frequently cause amenorrhoea, galactorrhoea and infertility and require dopamine agonist (DA) treatment to normalize prolactin levels and hence restore ovulation. The vast majority of female patients harbour microprolactinomas in whom DA treatment is usually discontinued at the time of pregnancy diagnosis, and surveillance is generally limited as symptomatic growth is considered very rare.

Case Descriptions: We report five cases of women harbouring a microprolactinoma in whom symptomatic pituitary apoplexy occurred during pregnancy. Read More

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Comparative analysis of pituitary adenoma with and without apoplexy in pediatric and adolescent patients: a clinical series of 80 patients.

Neurosurg Rev 2021 Apr 29. Epub 2021 Apr 29.

Department of Neurosurgery, The First Hospital of China Medical University, Nanjing Street 155, Heping District, Shenyang, 110001, China.

Pituitary adenomas (PAs) have a low incidence in pediatric and adolescent patients, and their clinical characteristics remain unclear. As a severe complication of PA, apoplexy was investigated in young patients in the present study. Eighty patients younger than 20 years with PAs who underwent surgery were included and divided into an apoplexy group and non-apoplexy group. Read More

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Apoplexy in sporadic pituitary adenomas: a single referral center experience and mutation analysis.

Arch Endocrinol Metab 2021 Apr 27. Epub 2021 Apr 27.

Centro de Pesquisas em Neuroendocrinologia/Seção de Endocrinologia, Faculdade de Medicina e Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil,

Objective: To analyze the clinical, laboratory, and radiological findings and management of patients with clinical pituitary apoplexy and to screen for aryl hydrocarbon receptor-interacting protein () mutations.

Methods: The clinical findings were collected from the medical records of consecutive sporadic pituitary adenoma patients with clinical apoplexy. Possible precipitating factors, laboratory data, magnetic resonance imaging (MRI) findings and treatment were also analyzed. Read More

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Neuro-Ophthalmic Emergencies.

Neurol Clin 2021 05 31;39(2):631-647. Epub 2021 Mar 31.

Department of Neurology and Neurological Sciences, Stanford University, 300 Pasteur Drive, Palo Alto, CA 94305, USA; Department of Ophthalmology, Stanford University, 2370 Watson Court, Palo Alto, CA 94303, USA. Electronic address:

Neuro-ophthalmic emergencies include optic nerve, central visual pathway, and ocular motility disorders that, if not identified and treated promptly, may lead to permanent vision loss, other significant morbidity, or mortality. This article provides a framework for approaching patients with neuro-ophthalmic symptoms and reviews the presentation, evaluation, and treatment of select emergent conditions that can cause them. Emergent causes of blurry vision, transient vision loss, papilledema, and diplopia, including giant cell arteritis, cardioembolic disease, and aggressive infection, are discussed. Read More

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Congenital nephrogenic diabetes insipidus accompanied with central nephrogenic diabetes secondary to pituitary surgery -a case report.

BMC Endocr Disord 2021 Apr 21;21(1):78. Epub 2021 Apr 21.

Department of Endocrinology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310003, Zhejiang province, China.

Background: Diabetes insipidus (DI) can be a common cause of polydipsia and polyuria. Here, we present a case of congenital nephrogenic diabetes insipidus (CNDI) accompanied with central diabetes insipidus (CDI) secondary to pituitary surgery.

Case Presentation: A 24-year-old Chinese woman came to our hospital with the complaints of polydipsia and polyuria for 6 months. Read More

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Restart of androgen deprivation therapy after goserelin induced pituitary apoplexy in a patient with disseminated prostate cancer a case report and five-years follow-up.

Urol Case Rep 2021 Jul 23;37:101648. Epub 2021 Mar 23.

Department of Oncology, The Norwegian Radiumhospitalet, Oslo University Hospital, Oslo, Norway.

Pituitary apoplexy is a clinical syndrome caused by hemorrhage or infarction of a pituitary adenoma. There have been a few reports in the literature of rapid onset of pituitary apoplexy after goserelin injection. To the best of our knowledge, there is no publication in the literature reporting re-introducing goserelin therapy for patients with prostate cancer after the onset of pituitary apoplexy. Read More

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GnRH agonist-associated pituitary apoplexy: a case series and review of the literature.

Pituitary 2021 Apr 9. Epub 2021 Apr 9.

Neuroendocrine Unit, Massachusetts General Hospital and Department of Medicine, Harvard Medical School, 100 Blossom Street, Cox140, Boston, MA, 02114, USA.

Purpose: To examine the clinical presentation and longitudinal outcome of Pituitary Apoplexy (PA) after gonadotropin-releasing hormone agonist (GnRHa) in a series of patients and compare to prior reports.

Methods: A retrospective chart review was performed on seven patients receiving GnRHa who developed PA. Prior reported cases were analyzed. Read More

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Retroclival epidural hematoma: A rare location of epidural hematoma, case report, and review of literature.

J Craniovertebr Junction Spine 2020 Oct-Dec;11(4):342-346. Epub 2020 Nov 26.

Department of Neurosurgery, Ibn-i Sina Hospital, Ankara University, Ankara, Turkey.

Retroclival epidural hematoma in adults is uncommon. Although most cases are associated with craniocervical trauma, other mechanisms have been reported, such as coagulopathy, vascular lesions, and pituitary apoplexy. We report two adults diagnosed with retroclival epidural hematoma. Read More

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November 2020

Asymptomatic pituitary apoplexy induced by corticotropin-releasing hormone in a 14 year-old girl with Cushing's disease.

J Pediatr Endocrinol Metab 2021 Apr 5. Epub 2021 Apr 5.

Paediatric Endocrinology Unit, Centro Hospitalar e Universitário do Porto, Porto, Portugal.

Objectives: Pituitary apoplexy is a rare complication of Cushing's disease (CD), especially in the paediatric age and even more rarely it can occur following anterior pituitary stimulation tests.

Case Presentation: We report a case of a 14-year-old girl who was admitted to our Hospital for evaluation of a possible Cushing's syndrome (CS). Her symptoms and initial laboratory tests were suggestive of CD. Read More

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Granulomatosis with polyangiitis masquerading as pituitary adenoma with apoplexy.

Mod Rheumatol Case Rep 2021 Apr 15:1-5. Epub 2021 Apr 15.

Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.

Granulomatosis with polyangiitis (GPA), formerly known as Wegener's granulomatosis, is a small- and medium-vessel autoimmune vasculitis. Rare presentations of GPA can manifest as ophthalmologic and endocrinological deficits with sellar enhancement on imaging. While GPA typically presents distinct in appearance from other sellar pathologies, such as pituitary adenoma, we report the case of a 41-year-old woman with GPA of the pituitary that was initially diagnosed as pituitary macroadenoma with apoplexy and treated with two surgical resections without improvement of clinical symptoms. Read More

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Long-Term Outcomes of Pituitary Gland Preservation in Pituitary Macroadenoma Apoplexy: Case Series and Review of the Literature.

J Neurol Surg B Skull Base 2021 Apr 11;82(2):182-188. Epub 2019 Nov 11.

Department of Neurological Surgery, Loyola University Stritch School of Medicine, Maywood, Illinois, United States.

 For patients presenting with neurological changes from pituitary tumor apoplexy, urgent surgical intervention is commonly performed for diagnosis, tumor resection, and optic apparatus decompression. Although identification and preservation of the pituitary gland during the time of surgery can be challenging, it may lead to improve endocrine outcomes.  A retrospective case series of all patients with macroadenomas presenting with apoplexy at Loyola University Medical Center from 2016 to 2018 was studied. Read More

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Pregnancy-associated diabetes insipidus in Japan-a review based on quoting from the literatures reported during the period from 1982 to 2019.

Endocr J 2021 Apr 23;68(4):375-385. Epub 2021 Mar 23.

Komatsu University#, Komatsu 923-0921, Japan.

This Review Article overviews the literature on diabetes insipidus (DI) associated with pregnancy and labor in Japan published from 1982 to 2019. The total number of patients collected was 361, however, only one-third of these cases had detailed pathophysiologic information enabling us to identify the respective etiology and subtype. Pregnancy-associated DI can be divided into 3 etiologies, central (neurogenic) DI, nephrogenic DI, and excess vasopressinase-associated DI. Read More

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Pituitary Apoplexy Attributed to COVID-19 Infection in the Absence of an Underlying Macroadenoma or Other Identifiable Cause.

Cureus 2021 Feb 12;13(2):e13315. Epub 2021 Feb 12.

Neurosurgery, Cleveland Clinic Florida, Weston, USA.

The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), is responsible for an array of extrapulmonary manifestations, including direct and indirect neurological complications. Currently, all published cases noting pituitary apoplexy in patients with COVID-19 have discovered underlying pituitary macroadenomas. Herein, we describe the first documented case, to our knowledge, of pituitary apoplexy attributed solely to COVID-19 in the absence of other identifiable causes. Read More

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February 2021

Neuro-ophthalmic presentation of COVID-19 disease: A case report.

Indian J Ophthalmol 2021 Apr;69(4):992-994

Department of Ophthalmology, Karnataka Institute of Medical Sciences, Hubballi, Karnataka, India.

COVID-19 is a respiratory virus, which has affected various organ systems as well. Here we report a neuro-ophthalmic presentation of pituitary apoplexy under the setting of COVID-19 infection in a middle-aged man who presented to ophthalmic emergency with sudden bilateral loss of vision along with a history of fever past 10 days. There was sluggishly reacting pupils and RT-PCR for COVID was positive. Read More

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Pituitary tumor apoplexy associated with extrapontine myelinolysis during pregnancy: A case report.

Medicine (Baltimore) 2021 Mar;100(10):e25075

Department of Radiology.

Rationale: Pituitary tumor apoplexy (PTA) is a rare clinical syndrome which requires urgent diagnosis and treatment due to its life-threatening consequences. Management of undiagnosed pituitary tumor before pregnancy is a problem during pregnancy.

Patient Concerns: We reported a case with PTA which was not diagnosed before pregnancy presenting with vomiting associated with hyponatremia during the third trimester. Read More

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Using acute hypervolaemic haemodilution as blood conservation technique in a Jehovah's witness patient undergoing an emergency transphenoidal surgery: a Sabah experience.

BMJ Case Rep 2021 Mar 4;14(3). Epub 2021 Mar 4.

Neurosurgery Department, Hospital Queen Elizabeth, Kota Kinabalu, Malaysia.

Jehovah's Witnesses (JW) is a branch of Christianity which was founded in 1872. However, their beliefs differ from other Christians in many ways. Majority of JW believe that it is against the teaching of God should they receive blood transfusion, while minority think receiving own blood or others is acceptable. Read More

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Pituitary apoplexy in the setting of COVID-19 infection: A case report.

Am J Emerg Med 2021 Feb 23. Epub 2021 Feb 23.

Department of Emergency Medicine, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92134, United States.

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February 2021

Surgical treatment of a 72-year-old patient with headache, hyponatremia and oculomotor nerve palsy: a case report and literature review.

Gland Surg 2021 Jan;10(1):364-370

Department of Neurosurgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.

Pituitary apoplexy is a life-threatening syndrome caused by acute infarction of the pituitary gland. The most common symptoms associated with pituitary apoplexy are headache, nausea, vomiting, visual symptoms, hypopituitarism, and altered mental status. Both oculomotor nerve palsy and hyponatremia are relatively rare complications of pituitary apoplexy. Read More

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January 2021

Key Factors Related to Internal Carotid Artery Stenosis Associated with Pituitary Apoplexy.

World Neurosurg 2021 May 7;149:e447-e454. Epub 2021 Feb 7.

Department of Neurosurgery, Nippon Medical School, Tokyo, Japan.

Background: Internal carotid artery (ICA) stenosis rarely occurs in pituitary apoplexy. Little is known of the causes of this condition. The present study investigated the factors related to ICA stenosis associated with pituitary apoplexy. Read More

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Syndrome of inappropriate antidiuretic hormone secretion in a patient with pituitary apoplexy.

BMJ Case Rep 2021 Feb 9;14(2). Epub 2021 Feb 9.

Department of Endocrinology, Diabetes and Metabolism, William Beaumont Hospital, Royal Oak, Michigan, USA.

Pituitary apoplexy (PA) is an endocrine emergency presenting with headache, visual and hormonal disturbances. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is rare after PA. A 64-year-old woman presented with acute frontal headache and nausea with normal neurological examination. Read More

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February 2021

Pituitary hemorrhage in pituitary adenomas treated with gamma knife radiosurgery: incidence, risk factors and prognosis.

J Cancer 2021 1;12(5):1365-1372. Epub 2021 Jan 1.

Department of Radiotherapy, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China. 510260.

: The aims of this study were to investigate the incidence, risk factors and prognosis of pituitary hemorrhage in pituitary adenomas treated with gamma knife radiosurgery (GKRS). Between December 1993 and December 2016, 751 consecutive pituitary adenoma patients treated with GKRS were retrospectively reviewed in a single center. There were 271 male (36. Read More

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January 2021

Postpartum headache after epidural anaesthesia: Who to blame?

Rev Esp Anestesiol Reanim 2021 Jan 28. Epub 2021 Jan 28.

Serviço de Anestesiologia, Centro Hospitalar e Universitário do Porto, Porto, Portugal; Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal.

Introduction: Epidural analgesia is considered the preferred analgesic choice during labour. Post dural puncture headache (PDPH) is considered a potential complication of this analgesic technique and is a frequently hypothesis for any headache occurring after delivery. It is essential that anaesthetists and obstetricians are familiar with other possible differential diagnosis for postpartum headache (PPH). Read More

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January 2021

A Rare Case of SARS-CoV-2 Infection Associated With Pituitary Apoplexy Without Comorbidities.

J Endocr Soc 2021 Mar 2;5(3):bvaa203. Epub 2021 Jan 2.

Department of Neurology, University Hospital "12 de Octubre," Madrid, Spain.

Pituitary apoplexy is a medical and surgical emergency caused by hemorrhage or infarction of the hypophysis, which typically occurs within a pituitary adenoma. It is usually characterized by severe (often thunderclap) headache, visual disturbances, cranial nerve impairments, and hormonal deficiencies. We herein report a case of a previously healthy woman with severe acute respiratory syndrome coronavirus 2 infection associated with pituitary apoplexy. Read More

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Outcomes of pituitary apoplexy: a comparison of microadenomas and macroadenomas.

Pituitary 2021 Jan 19. Epub 2021 Jan 19.

Institute of Endocrinology, Diabetes and Metabolism, Rambam Health Care Campus, HaAliya HaShniya Street 8, 3109601, Haifa, Israel.

Purpose: We aimed to assess clinical characteristics of apoplexy of pituitary microadenomas compared to macroadenomas.

Methods: We retrieved clinical records of patients > 18 years old, hospitalized in Rambam hospital between January 2001 and October 2017, with pituitary apoplexy and follow-up of at least one year. We compared clinical course and outcomes of apoplexy between patients with microadenomas and macroadenomas, and between patients who received conservative or surgical treatment. Read More

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January 2021