Pituitary apoplexy history and symptoms: Difference between revisions
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[[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]] | *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]]). | ||
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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]]. | ||
Over time, problems with other pituitary hormones may develop, causing symptoms of the following conditions: | Over time, problems with other [[Pituitary hormone|pituitary hormones]] may develop, causing symptoms of the following conditions: | ||
*[[Growth hormone]] deficiency | *[[Growth hormone]] deficiency | ||
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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.