Pituitary apoplexy – Quick review chart

Pituitary apoplexy Damage to the pituitary gland due to reduced blood flow , Infarction or haemorrhage- causes " sudden death " of the gland.

tumor expands due to haemorrhage ( main reason for symptoms ) pressure on the optic nerve or chiasm causes visual manifestations sudden interruption in release of hormone causes hormonal dysfunction

Higher risk pre-existing pituitary adenoma patients are usually unaware of the condition about 5 % with pre-existing adenoma may develop apoplexy bigger the tumor ( macroadenoma ) greater the risk precipitants can be endocrine stimulation tests , bromocriptine or cabergoline treatment , gonadotrophin releasing hormone treatment ,lumbar fusion in prone position ,pregnancy , pituitary irradiation , anticoagulation , thrombocytopenia , erectile dysfunction medications , ↑ or ↓ BP , surgery , infections.

Classic triad headache vomiting visual impairment , sudden onset headache located behind the eye change in eye-sight as double vision , restriction of eye movement , hemianopia , ptosis diplopia - extrinsic compression of one or several extraocular nerve drowsiness lack of ACTH -adrenal crisis

Sheehan syndrome -in post-partum women necrosis of the gland following sig bleeding during childbirth presentation is with adrenal insufficiency , hypothyroidism , hypopituitarism

Imaging ( CT , MRI )...