Pituitary Apoplexy
- Pituitary apoplexy is characterized by headache, visual loss, meningism, ophthalmoplegia, vomiting, hormonal dysfunction, and altered mental status caused by sudden hemorrhage or infarction of the gland.
- It is more common in patients with previously undiagnosed pituitary adenomas or, less commonly, in a nonadenomatous gland having been described in association with therapeutic anticoagulation and thrombocytopenia.
- The anterior pituitary gland is perfused by its portal venous system, which passes down the hypophyseal stalk. This unusual vascular supply likely contributes to frequency of pituitary apoplexy.
- This is a rare, life threatening neurological emergency. Pituitary apoplexy can cause devastating and instantaneous effects on previously normal pituitary function. Immediate administration of corticosteroids is mandatory due to the high incidence (2/3 of patients) demonstrating acute adrenal insufficiency.
Suggested Reading
Silberstein L, Johnston C, Tibi L, et al. Pituitary apoplexy during induction chemotherapy for acute myeloid leukaemia. Br J Haematol 2008;143:151.
Rogg JM, Tung GA, Anderson G, et al. Pituitary Apoplexy: Early Detection with Diffusion-Weighted MR Imaging. AJNR Am J Neuroradiol 2002;23:1240-45.