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Diagnosis and management of pituitary apoplexy:a Tunisian data

Chinese Neurosurgical Journal 2023年第3期9卷 183-189页

作者： faten hadj kacem Oumeyma Trimeche Imen Gargouri Dhoha Ben Salah Nadia Charfi Nabila Rekik Fatma Mnif Mouna Mnif Mouna Elleuch Mohammed Abid Hedi Chaker Hospital 3029 SfaxTunisia

Background Pituitary apoplexy(PA)is defined as the hemorrhage or the infraction of a pituitary *** to determine the epidemiological,clinical,paraclinical characteristics as well as management and outcomes of PA in our population,we conducted this cross-sectional *** This cross-sectional study was conducted at the Department of Endocrinology of Hedi chaker university hospital,*** was collected from medical charts of patients with pituitary apoplexy admitted in our department between 2000 and *** We included 44 patients with *** mean age was 50±12.6 *** them,31.8%had a known pituitary adenoma,and it was in all cases a macroadenoma,predominantly a prolactin secreting tumor(42.8%).A triggering factor of PA was encountered in 31.8%of cases and it was mainly:head trauma,dopamine antagonists,and *** clinical presentation of PA encompassed headaches(84.1%),visual disturbances(75%),and neurological signs(40.9%).Gonadotropin deficiency was the most frequent form of hypopituitarism noted(59.1%),followed by corticotropin deficiency(52.3%),thyrotropin deficiency(47.7%),and somatotropin deficiency(2.3%).Hormonal assessment at PA onset,concluded that 23 had a secreting adenoma:18 prolactinomas,3 ACTH-secreting adenomas,and 2 GH-secreting *** the 21 remaining cases,the tumor was non-functioning(47.7%).Pituitary MRI was performed in 42 cases(95.5%),revealing infraction and or hemorrhage in the pituitary gland in 33 cases;a heterogenous signal or a fluid level within the adenoma,in nine *** administration of intra venous hydrocortisone was required in 19 *** administration was mandatory in a patient who had severe intracranial *** management of the PA was imperative in 24 patients(54.5%):15 suffered from severe visual impairment,4 had an intracranial hypertension,2 cases demonstrated an impaired consciousness,2 patients experienced a tumor enlargement and one case had a severe

关键词： Pituitary apoplexy Pituitary neoplasms Neurosurgery Dopamine antagonists

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