Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Surgical Outcomes of Pituitary Apoplexy

  • Kim, Jin-Kyung (Department of Neurosurgery, Dankook University College of Medicine) ;
  • Park, Bong-Jin (Department of Neurosurgery, Dankook University College of Medicine) ;
  • Cho, Keun-Tae (Department of Neurosurgery, Dankook University College of Medicine) ;
  • Lee, Sang-Koo (Department of Neurosurgery, Dankook University College of Medicine) ;
  • Cho, Maeng-Ki (Department of Neurosurgery, Dankook University College of Medicine) ;
  • Kim, Young-Joon (Department of Neurosurgery, Dankook University College of Medicine)
  • Published : 2005.12.28
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Abstract

Objective : Pituitary apoplexy is a rare clinical syndrome caused by pituitary hemorrhage, hemorrhagic infarction, or ischemic infarction within a pituitary tumor or surrounding structure. We analyzed surgical outcomes of pituitary apoplexy. Methods : From 1995 to 2004, we reviewed our experience of 29 cases with pituitary apoplexy. In all patients, pre- and postoperative clinical presentation were checked and endocrine study were performed. Results : The most frequent symptoms were visual disturbance [24 cases, 82.8%] and headache [22 cases, 75.9%]. After surgery, headache improved in 86.4%, 88.9% among 18cases who had preoperative reduction in visual acuity and 75.0% among 12 cases who had preoperative reduction in visual field improved. In endocrine study, long-term steroid and thyroid hormone replacement therapy was necessary in 42.9% of 14 cases presenting preoperative hypopituitarism. Postoperative transient hypopituitarism developed in 5 cases [33.3%] and they all recovered in follow up study. Postoperative endocrinological recovery were in 77.9% of 9 cases with preoperative prolactinoma, 1 case in 2 cases with acromegaly and one case with Cushing disease. Postoperative complications were diabetes inspidus[DI] in 1 case [3.4%]. cerebrospinal fluid[CSF] leakage in 2 cases [6.8%] and death in 1 case [3.4%] due to sepsis, Conclusion : We report good results through surgery of pituitary apoplexy in a clinical and endocrine outcomes. The surgery should be performed as soon as possible to be a suitable method for treating pituitary apoplexy.

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References

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