Diagnosis and Treatment of Pituitary Apoplexy, A True Endocrine Emergency

IF 4.7 3区 医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Archives of Medical Research Pub Date : 2024-05-03 DOI:10.1016/j.arcmed.2024.103001
Alberto Moscona-Nissan, Jessica Sidauy-Adissi, Karla Ximena Hermoso-Mier, Shimon Shlomo Glick-Betech, Leonel de Jesús Chávez-Vera, Florencia Martinez-Mendoza, Oscar Mario Delgado-Casillas, Keiko Taniguchi-Ponciano, Daniel Marrero-Rodríguez, Moisés Mercado
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Abstract

Pituitary apoplexy (PA) is a clinical syndrome resulting from a hemorrhagic infarction of the pituitary gland. It is characterized by the sudden onset of visual disturbances, nausea, vomiting, headache and occasionally, signs of meningeal irritation and an altered mental status. The exact pathogenesis of PA remains to be elucidated, although tumor overgrowth of its blood supply remains the most popular theory. Main risk factors for the development of PA include systemic, iatrogenic, and external factors as well as the presence of an underlying pituitary tumor. The diagnostic approach of PA includes both neuroimaging and evaluation of pituitary secretory function.

PA is a potentially life-threatening condition which should be managed with hemodynamic stabilization, correction of electrolyte abnormalities and replacement of hormonal deficiencies. PA treatment should be individualized based on the severity of the clinical picture which may vary widely. Treatment options include conservative management with periodic follow-up or neurosurgical intervention, which should be decided by a multidisciplinary team. We conducted a systematic review of the literature to unveil the frequency of PA predisposing factors, clinical and biochemical presentations, management strategies and outcomes.

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垂体性脑瘫的诊断和治疗,真正的内分泌急症
垂体性脑瘫(PA)是垂体出血性梗死引起的一种临床综合征。其特征是突然出现视觉障碍、恶心、呕吐、头痛,偶尔也会出现脑膜刺激症状和精神状态改变。PA 的确切发病机制仍有待阐明,但肿瘤供血过度仍是最流行的理论。PA 发病的主要危险因素包括系统性、先天性和外部因素,以及存在潜在的垂体瘤。PA 的诊断方法包括神经影像学检查和垂体分泌功能评估。PA 是一种可能危及生命的疾病,应通过稳定血流动力学、纠正电解质异常和补充激素缺乏来控制病情。PA 的治疗应根据临床表现的严重程度因人而异,而临床表现的严重程度可能差异很大。治疗方案包括定期随访的保守治疗或神经外科干预,这应由多学科团队共同决定。我们对文献进行了系统性回顾,以揭示 PA 的诱发因素、临床和生化表现、管理策略和结果。
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来源期刊
Archives of Medical Research
Archives of Medical Research 医学-医学:研究与实验
CiteScore
12.50
自引率
0.00%
发文量
84
审稿时长
28 days
期刊介绍: Archives of Medical Research serves as a platform for publishing original peer-reviewed medical research, aiming to bridge gaps created by medical specialization. The journal covers three main categories - biomedical, clinical, and epidemiological contributions, along with review articles and preliminary communications. With an international scope, it presents the study of diseases from diverse perspectives, offering the medical community original investigations ranging from molecular biology to clinical epidemiology in a single publication.
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