Rolih C A, Ober K P
Department of Internal Medicine, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina.
Endocrinol Metab Clin North Am. 1993 Jun;22(2):291-302.
Pituitary apoplexy is a clinical syndrome of headache, visual deficits, ophthalmoplegia, and alteration in mental status resulting from the sudden hemorrhage or infarction of a pituitary adenoma. Infarction of a normal gland also may occur in certain circumstances. Its manifestations are variable, ranging from a clinically benign event to a catastrophic presentation with permanent neurologic deficits or even death. It frequently mimics other intracranial processes and, without a high index of suspicion, may be difficult to diagnose. Radiographic studies, particularly CT and MR imaging, are helpful for diagnosis in both the acute and subacute settings. In its most fulminant presentation, prompt neurosurgical decompression is necessary to preserve sight and life. Corticosteroid replacement is also essential in the acute phase because of the high incidence of adrenal insufficiency. Fortunately, however, with proper management most patients may have good outcomes.
垂体卒中是一种临床综合征，表现为头痛、视力缺损、眼肌麻痹以及因垂体腺瘤突然出血或梗死导致的精神状态改变。在某些情况下，正常垂体腺也可能发生梗死。其表现多样，从临床良性事件到伴有永久性神经功能缺损甚至死亡的灾难性表现不等。它常模仿其他颅内病变，若没有高度的怀疑指数，可能难以诊断。影像学检查，尤其是CT和磁共振成像，在急性期和亚急性期对诊断均有帮助。在其最暴发性的表现中，需要及时进行神经外科减压以挽救视力和生命。由于肾上腺功能不全的发生率高，急性期使用皮质类固醇替代治疗也至关重要。然而，幸运的是，通过适当的管理，大多数患者可能会有良好的预后。
