Endocrine Abstracts

Background and aims: Pituitary apoplexy (PA) is a rare clinical syndrome due to pituitary hemorrhage or infarction. It is an emergent and potential life-threatening complication of pituitary adenomas if not managed properly. It is usually characterized by the sudden onset of one or more of the following: severe headache, visual disturbance, nausea/vomiting, and or altered mental status. We aimed to present clinical and biochemical characteristics as well as management of patients presented with pituitary apoplexy at our department.

Methods: In this study, a total of 14 patients presented with pituitary apoplexy between 2012 and 2022. The data of pituitary apoplexy cases were recorded. Resection rates, hormonal results, and clinical presentation of patients with pituitary apoplexy were evaluated.

Results: Over the last 10 years, 14 patients (2 women) were hospitalized for pituitary apoplexy. The median age of patients was 64.57±16.11 years. Only one patient had a prolactinoma, the rest of them were non-functioning adenomas. Acute and severe headache was the most frequent symptom (100%), followed by visual disturbances 9/14 (64.3%) and diplopia 6/14 (42.9%). At presentation, the majority of patients 10/14 (71,42%) had one or more anteiror pituitary deficiencies. 3 of 14 tumors (21.4%) were causing cavernous sinus invassion. The median maximum diameter of the tumor was 28.2±9.7 mm. Nine of fourteen patients (64,3%) underwent transsphenoidal surgery due to visual fields deffects or aggressive tumor.

Conclusion: Severe headache and visual disturbances are the commonest symptoms. Transsphenoidal surgery is the most frequent management.