Pituitary apoplexy history and symptoms: Difference between revisions
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==Symptoms== | ==Symptoms== | ||
Pituitary | Pituitary apoplexy usually has a short period of [[symptoms]] (acute), but it can be life-threatening. | ||
Symptoms usually include:<ref name="pmid28437813">{{cite journal |vauthors=Pyrgelis ES, Mavridis I, Meliou M |title=Presenting Symptoms of Pituitary Apoplexy |journal=J Neurol Surg A Cent Eur Neurosurg |volume= |issue= |pages= |year=2017 |pmid=28437813 |doi=10.1055/s-0037-1599051 |url=}}</ref><ref name="pmid10468988">{{cite journal| author=Randeva HS, Schoebel J, Byrne J, Esiri M, Adams CB, Wass JA| title=Classical pituitary apoplexy: clinical features, management and outcome. | journal=Clin Endocrinol (Oxf) | year= 1999 | volume= 51 | issue= 2 | pages= 181-8 | pmid=10468988 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10468988 }} </ref> | [[Symptoms]] usually include:<ref name="pmid28437813">{{cite journal |vauthors=Pyrgelis ES, Mavridis I, Meliou M |title=Presenting Symptoms of Pituitary Apoplexy |journal=J Neurol Surg A Cent Eur Neurosurg |volume= |issue= |pages= |year=2017 |pmid=28437813 |doi=10.1055/s-0037-1599051 |url=}}</ref><ref name="pmid10468988">{{cite journal| author=Randeva HS, Schoebel J, Byrne J, Esiri M, Adams CB, Wass JA| title=Classical pituitary apoplexy: clinical features, management and outcome. | journal=Clin Endocrinol (Oxf) | year= 1999 | volume= 51 | issue= 2 | pages= 181-8 | pmid=10468988 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10468988 }} </ref> | ||
*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 [[Muscle|muscles]] ([[ophthalmoplegia]]), causing double vision ([[diplopia]]) . It can be due to [[intra]][[cavernous]] expansion of the [[tumor]] mass or a sudden increase in pressure in the [[pituitary]] region. | *[[Paralysis]] of the eye [[Muscle|muscles]] ([[ophthalmoplegia]]), causing double vision ([[diplopia]]). It can be due to [[intra]][[cavernous]] 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]]. | ||
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]]. | 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]]. | ||
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**Lack of energy | **Lack of energy | ||
*[[Hypoadrenalism]] (if not already present or treated) | *[[Hypoadrenalism]] (if not already present or treated) | ||
**Inability to deal with physical stress | **Inability to deal with physical [[Stress (medicine)|stress]] | ||
**[[Nausea]] | **[[Nausea]] | ||
*[[Hypogonadism]] | *[[Hypogonadism]] | ||
**Absent periods ([[amenorrhea]]) in women | **Absent periods ([[amenorrhea]]) in women | ||
**[[Sexual dysfunction]] and loss of muscle mass in men | **[[Sexual dysfunction]] and loss of [[muscle mass]] in men | ||
*[[Hypothyroidism]] | *[[Hypothyroidism]] | ||
**Cold intolerance | **Cold intolerance | ||
| Line 36: | Line 36: | ||
**[[Depressed mood]] | **[[Depressed mood]] | ||
**[[Dry skin]] | **[[Dry skin]] | ||
**Fatigue | **[[Fatigue]] | ||
**Hair or skin changes | **[[Hair]] or [[skin changes]] | ||
**[[Hoarseness]] | **[[Hoarseness]] | ||
**Menstrual changes | **[[Menstrual]] changes | ||
**Mental slowing | **Mental slowing | ||
**[[Weight gain]] | **[[Weight gain]] | ||
When the [[posterior pituitary]] is involved (rare), symptoms may include: | 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 of the [[uterus]] to contract as needed to give [[birth]] to a baby (in women) | ||
*Failure to produce [[breast milk]] (in women) | *Failure to produce [[breast milk]] (in women) | ||
*Uncontrolled [[urination]] | *Uncontrolled [[urination]] | ||
Revision as of 18:34, 28 July 2017
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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]
Overview
Pituitary apoplexy usually has a short period of symptoms (acute), but it can be life-threatening. Symptoms usually include severe headache, paralysis of eye muscles, visual disturbances, nausea and vomitting.
Symptoms
Pituitary apoplexy usually has a short period of symptoms (acute), but it can be life-threatening.
Symptoms usually include:[1][2]
- 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)
- 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
References
- ↑ Pyrgelis ES, Mavridis I, Meliou M (2017). "Presenting Symptoms of Pituitary Apoplexy". J Neurol Surg A Cent Eur Neurosurg. doi:10.1055/s-0037-1599051. PMID 28437813.
- ↑ Randeva HS, Schoebel J, Byrne J, Esiri M, Adams CB, Wass JA (1999). "Classical pituitary apoplexy: clinical features, management and outcome". Clin Endocrinol (Oxf). 51 (2): 181–8. PMID 10468988.