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Journal of Korean Neurosurgical Society > Volume 38(6); 2005 > Article
Journal of Korean Neurosurgical Society 2005;38(6): 450-455.
Surgical Outcomes of Pituitary Apoplexy.
Jin Kyung Kim, Bong Jin Park, Keun Tae Cho, Sang Koo Lee, Maeng Ki Cho, Young Joon Kim
Department of Neurosurgery, Dankook University College of Medicine, Cheonan, Korea.
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.
Key Words: Pituitary apoplexy; Transsphenoidal approach; Surgical outcome
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