Pituitary apoplexy

Question 1

What is pituitary apoplexy?

Answer 1

Infarction of the pituitary gland as a result of ischemia and/or hemorrhage

Question 2

What are the causes of pituitary apoplexy?

Answer 2

Most commonly occurs in patients with a pre-existing pituitary adenoma
(Sheehan syndrome) postpartum necrosis of the pituitary gland. Usually occurs following postpartum hemorrhage, but can also occur even without clinical evidence of hemorrhage
(Traumatic brain injury)

Question 3

What are the clinical features of pituitary apoplexy?

Answer 3

(Immediate) Effects of reduced cortisol or ACTH: hypoglycemia, low blood pressure, loss of consciousness
(Gradual) Effect of reduced pituitary hormones (see hypopituitarism)

Question 4

How is pituitary apoplexy diagnosed?

Answer 4

(MRI)

Hormone blood tests

Question 5

What is the treatment for pituitary apoplexy?

Answer 5

(Immediate glucocorticoid replacement)
(Life-long hormonal replacement)
(Trans-sphenoidal resection)