Department of Neurosurgery, Gaziantep University Faculty of Medicine, Gaziantep-Turkey.
Department of Neurosurgery, University of Health Sciences, Gülhane Training and Research Hospital, Ankara-Turkey.
Ulus Travma Acil Cerrahi Derg. 2022 Apr;28(4):483-489. doi: 10.14744/tjtes.2021.93539.
Pituitary apoplexy is an emergent and potential life-threatening complication of pituitary adenomas if not managed properly. The aim of our study is to present our series of pituitary adenomas and to focus on the clinical, radiological, and surgical characteristics of this rare complication.
In this study, a total of 143 patients with pituitary adenoma underwent surgical treatment between 2016 and 2018. All patients were operated using endoscopic endonasal transsphenoidal (EET) technique. The data of pituitary apoplexy cases were recorded. Resection rates, hormonal results, and visual outcomes of patients with pituitary apoplexy were evaluated.
Of the 143 patients, 8 (5.59%) were presented with the symptoms and radiological findings of pituitary apoplexy. The mean age was 26.75 years, and 4 (50%) of them were male and 4 were female. Pre-operative mean Knosp grading score was 2.1 All of eight patients underwent emergent surgical intervention and total resection was achieved in 75% of patients with apoplexy. Hormone levels were significantly decreased after surgery (p<0.05), except prolactin (p>0.05). Cerebrospinal fluid leakage occurred in one pa-tient. None of the patient with pituitary apoplexy died in our series.
Pituitary apoplexy is an important complication of pituitary adenomas. Early diagnosis and surgical intervention provide excellent ophthalmological and hormonal outcomes. Emergent EET approach is crucial for patients with ophthalmological findings and macroadenomas.
垂体卒中是垂体腺瘤的一种紧急且潜在的危及生命的并发症，如果处理不当。我们研究的目的是介绍我们的垂体腺瘤系列，并重点介绍这种罕见并发症的临床、放射学和手术特点。
在这项研究中，共有 143 例垂体腺瘤患者在 2016 年至 2018 年期间接受了手术治疗。所有患者均采用内镜经鼻蝶窦（EET）技术进行手术。记录垂体卒中病例的数据。评估垂体卒中患者的切除率、激素结果和视力结果。
在 143 例患者中，有 8 例（5.59%）出现了垂体卒中的症状和放射学表现。平均年龄为 26.75 岁，其中 4 例（50%）为男性，4 例为女性。术前平均 Knosp 分级评分为 2.1。所有 8 例患者均行紧急手术干预，其中 75%的卒中患者达到了全切。术后激素水平显著下降（p<0.05），除泌乳素（p>0.05）外。1 例患者发生脑脊液漏。在我们的研究中，没有垂体卒中患者死亡。
垂体卒中是垂体腺瘤的一种重要并发症。早期诊断和手术干预可提供良好的眼科和激素结果。对于有眼科表现和大腺瘤的患者，紧急 EET 方法至关重要。
