Pituitary apoplexy history and symptoms: Difference between revisions
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*Severe [[headache]]. It is generally the first symptom to appear (seen in 80% of patients). | *Severe [[headache]]. It is generally the first symptom to appear (seen in 80% of patients). | ||
*Paralysis of the eye muscles ([[ophthalmoplegia]]), causing double vision (diplopia) . It can be due to intracavernous expansion of the tumor mass or a sudden increase | *Paralysis of the eye muscles ([[ophthalmoplegia]]), causing double vision (diplopia) . It can be due to intracavernous expansion of the tumor mass or a sudden increase in pressure in the pituitary region. | ||
*Visual disturbances from compression of surrounding structures (optic chiasm and optic tract). | *Visual disturbances from compression of surrounding structures (optic chiasm and optic tract). | ||
*Extravasation of blood into subarachnoid space can lead to signs of meningeal irritation such as nausea, vomitting, photophobia and meningismus. | *Extravasation of blood into subarachnoid space can lead to signs of meningeal irritation such as nausea, vomitting, photophobia and meningismus. | ||
*Low [[blood pressure]], [[nausea]], and [[vomit]]ing from [[acute adrenal insufficiency]] | *Low [[blood pressure]], [[nausea]], and [[vomit]]ing from [[acute adrenal insufficiency]] | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Akshun Kalia M.B.B.S.[2]
Symptoms
Pituitary infarction usually has a short period of symptoms (acute), but it can be life-threatening.
Symptoms usually include:
- Severe headache. It is generally the first symptom to appear (seen in 80% of patients).
- Paralysis of the eye muscles (ophthalmoplegia), causing double vision (diplopia) . It can be due to intracavernous expansion of the tumor mass or a sudden increase in pressure in the pituitary region.
- Visual disturbances from compression of surrounding structures (optic chiasm and optic tract).
- Extravasation of blood into subarachnoid space can lead to signs of meningeal irritation such as nausea, vomitting, photophobia and meningismus.
- Low blood pressure, nausea, and vomiting from acute adrenal insufficiency
Less commonly, pituitary dysfunction may appear more slowly. In Sheehan syndrome, for example, the first symptom may be a failure to produce milk caused by lack of the hormone prolactin.
Over time, problems with other pituitary hormones may develop, causing symptoms of the following conditions:
- Growth hormone deficiency
- Fatigue
- Increased fat in the abdomen
- Lack of energy
- Hypoadrenalism (if not already present or treated)
- Inability to deal with physical stress
- Nausea
- Hypogonadism
- Absent periods (amenorrhea) in women
- Sexual dysfunction and loss of muscle mass in men
- Hypothyroidism
- Cold intolerance
- Constipation
- Depressed mood
- Dry skin
- Fatigue
- Hair or skin changes
- Hoarseness
- Menstrual changes
- Mental slowing
- Weight gain
When the posterior pituitary is involved (rare), symptoms may include:
- Failure of the uterus to contract as needed to give birth to a baby (in women)
- Failure to produce breast milk (in women)
- Uncontrolled urination