American Journal of BioMedicine Volume 10, Issue 1, pages 6-12
Hongmei Xu 1, Xue Nan Zong 1, Rui- Qin Yu2
Abstract
Pituitary apoplexy can be a life-threatening condition, which is not easily diagnosed or treated. Predisposing factors of pituitary apoplexy include bromocriptine treatment, head trauma, pregnancy, pituitary irradiation, anticoagulation. Apoplexy may occur during pregnancy with appropriately managed, visual symptoms often improve, but endocrinologic function may remain compromised. This case reported that 30-year-old female full term vaginal delivery after years of primary infertility presented in emergency department with headache and blurred vision and diplopia, CNS examination unremarkable except third cranial nerve palsy. In conclusion, pituitary apoplexy is a rare cause of sudden and severe attack of headache during pregnancy. A multidisciplinary team needs to reduce morbidity and mortality.
Keywords: Pituitary apoplexy; Diplopia; Primary infertility
Copyright © 2022 by American Journal of BioMedicine, Inc.
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- Le Roux CW, Meeran K, Alaghband-Zadeh J. Is a 0900-h serum cortisol useful prior to a short Synacthen test in outpatient assessment? Ann Clin Biochem. 2002; 39: 148-50.
https://doi.org/10.1258/0004563021901919 - Turgut M, Ozsunar Y, Başak S, Güney E, Kir E, Meteoğlu I. Pituitary apoplexy: An overview of 186 cases published during the last century. Acta Neurochir (Wien). 2010; 152: 749-61.
https://doi.org/10.1007/s00701-009-0595-8 - Bonicki W, Kasperlik-Załuska A, Koszewski W, Zgliczyñski W, Wisławski J. Pituitary apoplexy: Endocrine, surgical and oncological emergency. Incidence, clinical course and treatment with reference to 799 cases of pituitary adenomas. Acta Neurochir (Wien). 1993; 120: 118-22.
https://doi.org/10.1007/BF02112028 - Grand'Maison S, Weber F, Bédard M-J, et al. Pituitary apoplexy in pregnancy: a case series and literature review. Obstet Med. 2015; 8: 177-83.
https://doi.org/10.1177/1753495X15598917 - Lomban E, Bonneville F, Karachi C, Abdennour L, Dormont D, Chiras J. Massive stroke in a patient with pituitary apoplexy, cervical carotid artery stenosis and hypotension. J Neuroradiol. 2006; 33: 259-262.
https://doi.org/10.1016/S0150-9861(06)77272-8 - Karaca Z, Tanriverdi F, Unluhizarci K, et al. Pregnancy and pituitary disorders. Eur J Endocrinol. 2010; 162: 453-75.
https://doi.org/10.1530/EJE-09-0923 - Rajasekaran S, Vanderpump M, Baldeweg S, et al. UK guidelines for the management of pituitary apoplexy. Clin Endocrinol (Oxf). 2011; 74: 9-20.
https://doi.org/10.1111/j.1365-2265.2010.03913.x - Catenoix H, Nighoghossian N, Honnorat J, et al. Necrosis of a hypophyseal adenoma and ischemic cerebral vascular accident. Rev Neurol (Paris). 2002; 158: 734-736.
- Semple PL, Jane JA, Jr, Lopes MB, Laws ER. Pituitary apoplexy: Correlation between magnetic resonance imaging and histopathological results. J Neurosurg. 2008; 108: 909-15.
https://doi.org/10.3171/JNS/2008/108/5/0909 - Kachhara R, Nair S, Gupta AK. Spontaneous resolution of a non-functioning pituitary adenoma following an apoplexy. Neurol India. 2000; 48: 294-6.
- Verrees M, Arafah BM, Selman WR. Pituitary tumor apoplexy: characteristics,
treatment, and outcomes. Neurosurg Focus. 2004; 16: 1-7.
https://doi.org/10.3171/foc.2004.16.4.7 - Agrawal D, Mahapatra AK. Pituitary apoplexy and inappropriate ADH secretion. J Clin Neurosci. 2003; 10: 260-1.
https://doi.org/10.1016/S0967-5868(03)00002-X - Lath R, Rajshekhar V. Massive cerebral infarction as a feature of pituitary apoplexy. Neurol India. 2001; 49: 191-193.
- Frieze TW, Mong DP, Koops MK. Hook effect" in prolactinomas: Case report and review of literature. Endocr Pract. 2002; 8: 296-303.
https://doi.org/10.4158/EP.8.4.296 - Mohindra S, Kovai P, Chhabra R. Fatal bilateral ACA territory infarcts after pituitary apoplexy: A case report and literature review. Skull Base. 2010; 20: 285-8.
https://doi.org/10.1055/s-0030-1249243 - Chokyu I, Touyuguchi N, Goto T, Chokyu K, Chokyu M, Ohata K. Pituitary apoplexy causing internal carotid artery occlusion: Case report. Neurol Med Chir (Tokyo). 2011; 51: 48-51.
https://doi.org/10.2176/nmc.51.48 - Baldeweg SE, Vanderpump M, Drake W, et al. Society for endocrinology endocrine emergency guidance: emergency management of pituitary apoplexy in adult patients. Endocr Connect. 2016; 5: G12-15.
https://doi.org/10.1530/EC-16-0057 - Muthukumar N, Rossette D, Soundaram M, Senthilbabu S, Badrinarayanan T. Blindness following pituitary apoplexy: Timing of surgery and neuro-ophthalmic outcome. J Clin Neurosci. 2008; 15: 873-9.
https://doi.org/10.1016/j.jocn.2007.08.010 - Zhang F, Chen J, Lu Y, Ding X. Manifestation, management, and outcome of subclinical pituitary adenoma apoplexy. J Clin Neurosci. 2009; 16: 1273-5.
https://doi.org/10.1016/j.jocn.2009.01.003 - Sibal L, Ball SG, Connolly V, et al. Pituitary apoplexy: A review of clinical presentation, management, and outcome in 45 cases. Pituitary. 2004; 7: 157-63.
https://doi.org/10.1007/s11102-005-1050-3 - Rivera J-A. Lymphocytic hypophysitis: disease spectrum and approach to diagnosis and therapy. Pituitary. 2006; 9: 35-45.
https://doi.org/10.1007/s11102-006-6598-z - Rotman-Pikielny P, Patronas N, Papanicolaou DA. Pituitary apoplexy induced by corticotrophin releasing hormone in a patient with Cushing's disease. Clin Endocrinol (Oxf) 2003; 58: 545-9.
https://doi.org/10.1046/j.1365-2265.2003.01720.x - Wongpraparut N, Pleanboonlers N, Suwattee P, et al. Pituitary apoplexy in a patient with acute myeloid leukemia and thrombocytopenia. Pituitary. 2000; 3: 113-6.
https://doi.org/10.1023/A:1009909908942 - Semple PL, Jane JA, Laws ER. Clinical relevance of precipitating factors in pituitary apoplexy. Neurosurgery. 2007; 61: 956-62.
https://doi.org/10.1227/01.neu.0000303191.57178.2a - Mou C, Han T, Zhao H, Wang S, Qu Y. Clinical features and immunohistochemical changes of pituitary apoplexy. J Clin Neurosci. 2009; 16: 64-8.
https://doi.org/10.1016/j.jocn.2008.02.012 - Zhu Q, Qian K, Jia G, et al. Clinical features, magnetic resonance imaging, and treatment experience of 20 patients with lymphocytic hypophysitis in a single center. World Neurosurg. 2019; 127: e22-9.
https://doi.org/10.1016/j.wneu.2019.01.250 - Liu ZH, Chang CN, Pai PC, et al. Clinical features and surgical outcome of clinical and subclinical pituitary apoplexy. J Clin Neurosci. 2010; 17: 694-9.
https://doi.org/10.1016/j.jocn.2009.11.012 - Woo HJ, Hwang JH, Hwang SK, Park YM. Clinical outcome of cranial neuropathy in patients with pituitary apoplexy. J Korean Neurosurg Soc. 2010; 48: 213- 8.
https://doi.org/10.3340/jkns.2010.48.3.213 - Nawar RN, AbdelMannan D, Selman WR. Pituitary tumor apoplexy: a review. BMJ Intensive Care Med. 2008; 23: 75-90.
https://doi.org/10.1177/0885066607312992 - Nawar RN, Abdel-Mannan D, Selma WR, Arafah BM. Pituitary tumor apoplexy: A review. J Intensive Care Med. 2008; 23: 75-89.
https://doi.org/10.1177/0885066607312992 - Rajasekaran S, Vanderpump M, Baldeweg S, et al. UK guidelines for the management of pituitary apoplexy. Clin Endocrinol. 2011; 74: 9-20.
https://doi.org/10.1111/j.1365-2265.2010.03913.x - Randeva H, Schoebel J, Byrne J, Esiri M, Adams C & Wass J. Classical pituitary apoplexy: clinical features, management, and outcome. Clinical Endocrinology. 1999; 52: 181-188.
https://doi.org/10.1046/j.1365-2265.1999.00754.x
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Blurred vision and diplopia in full term vaginal delivery women
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