Apoplexy accompanying pituitary adenoma as a complication of preoperative anterior pituitary function tests

  title={Apoplexy accompanying pituitary adenoma as a complication of preoperative anterior pituitary function tests},
  author={Atsuo Yoshino and Yoichi Katayama and T. Watanabe and Akiyoshi Ogino and Tsutomu Ohta and Chiaki Komine and Takakazu Yokoyama and Takashi Fukushima and Hamao Hirota},
  journal={Acta Neurochirurgica},
SummaryPituitary apoplexy occurs as a very rare complication of the pituitary function test. We have experienced two cases of pituitary apoplexy following anterior pituitary function tests for preoperative assessment: a triple bolus test and a TRH test. To elucidate such a rare complication, we outline our two cases and review 28 cases from the literature. The clinical characteristics, etiology, pathophysiology, and diagnostic and therapeutic implications are also discussed. The combined data… 

Pituitary Apoplexy Associated with Endocrine Stimulation Test: Endocrine Stimulation Test, Treatment, and Outcome

It is suggested that the necessity of endocrine stimulation test should be assessed on a case-by-case basis and in patients subjected to the test, and neurosurgical support should be sought.

Pituitary tumour apoplexy

The patients with mild, stable clinical picture (including those with isolated ocular palsies) can be managed conservatively with favourable visual and neurological outcome and the endocrinological outcome is less favourable, irrespective of the treatment option, with many patients remaining on long-term replacement therapy.

Management of endocrine disease: pituitary tumour apoplexy.

The optimal care of PA requires involvement of a multidisciplinary team including endocrinologist, neurosurgeon, neuroophthalmologist and the management strategy that depends on the clinical manifestations, as well as the presence of co-morbidities.

Pituitary apoplexy accompanying temporal lobe epilepsy as a complication: case report

The importance of recognition of temporal lobe epilepsy-like seizure due to pituitary apoplexy is emphasized, and it is suggested that early surgery should be considered as an option in patients displaying such a rare complication.

UK guidelines for the management of pituitary apoplexy a rare but potentially fatal medical emergency

Classic pituitary apoplexy is rare, characterised by the sudden onset of severe headache, vomiting, visual impairment and decreased consciousness caused by haemorrhage or infarction of thepituitary gland.

The Role of Conservative Management in Pituitary Apoplexy

Conservative treatment is an acceptable alternative for management of pituitary apoplexy in cases with less severe neuro-ophthalmic manifestations, otherwise early surgery should be performed.

UK guidelines for the management of pituitary apoplexy

It is suggested that further trials be carried out into the management of pituitary apoplexy to optimize treatment.

Pituitary tumor apoplexy

Sellar and Parasellar Region

Pituitary apoplexy induced by a combined anterior pituitary test: case report and literature review.

It is suggested that routine testing on pituitary function should be ordered cautiously given the risk of possible apoplexy, and gonadotropin-releasing hormone, TSH-re releasing hormone, and insulin were primarily responsible for the apopleXY.

Pituitary apoplexy probably due to TRH and GnRH stimulation tests in a patient with acromegaly

This case indicates that pituitary apoplexy may develop several days after TRH/GnRH stimulation test, in which a patient with severe headaches, nausea, vomiting, visual disturbance and mental alteration developed pneumonia and died on the 9th post-operative day.

Apoplexy of pituitary macroadenoma after combined test of anterior pituitary function.

A 34-year-old man with a GH-secreting pituitary macroadenoma and diabetes mellitus received an injection of 400 microg TRH, 100 microg GnRH, and 0.15 U/Kg regular insulin and complained of a severe headache and vomited, to the authors' knowledge, this is a very rare case of apoplexy of GH-Secretingpituitary adenoma after a combined stimulation test of anterior pituitarian function.

Pituitary apoplexy caused by endocrine stimulation tests: a case report.

Clinical versus subclinical pituitary apoplexy: presentation, surgical management, and outcome in 21 patients.

Although extensive pituitary hemorrhage often produced fulminant apoplexy, it also presented insidiously over many days with few, if any, clinical signs, and rapid diagnosis, endocrine replacement and transsphenoidal decompression constituted effective therapy.

Pituitary apoplexy and sudden blindness following the administration of gonadotrophin releasing hormone

This is the first time that GnRH administration has been associated with pituitary apoplexy of a glycoprotein secreting pituitsary adenoma.

Subarachnoid Haemorrhage and Vasospasm due to Pituitary Apoplexy After Pituitary Function Tests

A unique case of a 55-year-old man who presented with severe headache after a combined pituitary function test, and computed tomography evidence of an infarction, with subsequent intratumoural haemorrhage and subrachnoid haem orrhage associated with vasospasm is reported.

Apoplexy of a pituitary macroadenoma as a severe complication of preoperative thyrotropin-releasing hormone (TRH) testing.

  • I. SzabolcsN. Késmárki G. Szilágyi
  • Medicine
    Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association
  • 1997
It is concluded that TRH-testing is a risk for the patient with pituitary apoplexy and should be done only in selected cases.