Department of Neurosurgery, Adnan Menderes University Hospital, Aydin, Turkey.
Acta Neurochir (Wien). 2010 May;152(5):749-61. doi: 10.1007/s00701-009-0595-8. Epub 2010 Feb 6.
Pituitary apoplexy is a rare and life-threatening complication occurring in 0.6-10.5% of all cases of pituitary adenomas. Although the association between pituitary apoplexy and visual dysfunction has been recognized for a long time, the optimal management of this problem still remains controversial. The purpose of this overview was to present the surgical experience by analyzing the literature on the management of pituitary apoplexy for better treatment of these cases.
To establish a new guideline for the surgical treatment of this entity, publications reported during the last century and databases containing medical literature were analyzed. In addition, an illustrative case with pituitary apoplexy presenting with complaints of sudden onset severe headache associated with nausea, vomiting, and a sudden loss of vision was described. In fact, the experience in our complicated patient prompted us to review the available literature on the management of pituitary apoplexy to date.
Based on an overview of 186 cases of apoplectic pituitary adenoma presenting with monocular or binocular blindness, we highlight the importance of correct diagnosis and an early, but not necessarily emergency, surgery within the first week of admission to optimize visual outcome of such patients. The illustrative case further exemplifies the value of close interaction between members of the management team for optimal outcome.
垂体卒中是一种罕见且危及生命的并发症，在所有垂体腺瘤患者中发生率为 0.6-10.5%。尽管垂体卒中与视力障碍之间的关联很早就已被认识，但对于该问题的最佳治疗方法仍存在争议。本文旨在通过分析文献中关于垂体卒中治疗的经验，为更好地治疗这些病例提供一个手术经验的综述。
为建立针对该实体的新治疗指南，对上个世纪以来的出版物和包含医学文献的数据库进行了分析。此外，还描述了一例伴有垂体卒中的患者，其主要表现为突发严重头痛、恶心、呕吐和视力突然丧失。事实上，我们这位复杂患者的经验促使我们回顾了迄今为止有关垂体卒中治疗的可用文献。
基于对 186 例单眼或双眼失明的垂体卒中患者的综述，我们强调了正确诊断的重要性，并强调了在入院后的第一周内尽早进行手术，但不一定是紧急手术的重要性，以优化此类患者的视力预后。该病例进一步说明了管理团队成员之间密切互动对于获得最佳结果的价值。
