pituitary apoplexy
Last reviewed 01/2018
Pituitary apoplexy results from haemorrhage or infarction of the pituitary in 1-10% of patients with pituitary adenomas (1).
Pituitary apoplexy has very rarely been described during pregnancy, when it is potentially life-threatening to both the mother and the fetus (2).
It is characterised by:
- severe headache of acute onset, similar to that in subarachnoid haemorrhage
- neck stiffness may be present
- rapidly progressive visual impairment
- extraocular nerve palsies
- primary pituitary insufficiency
- stupor and then coma
Steroid cover - iv. hydrocortisone, attention to fluid balance, and early transphenoidal surgery are necessary.
Survivors require lifelong replacement therapy for the resultant hypopituitarism.
Reference:
- Kuvera . Pituitary Tumours. Med. Int 1993;21:5
- Piantanida E et al. Pituitary apoplexy during pregnancy: a rare, but dangerous headache.J Endocrinol Invest. 2014