Pituitary apoplexy
- massive infarction of the pituitary gland
- possible pathophysiology: rapidly growing pituitary adenoma outstrips its blood supply thereby causing ischemic necrosis followed by hemorrhage
- risk factors: pregnancy, usage of bromocriptine, estrogen, head trauma
- pituitary gland sits next to cavernous sinus and optic chiasm
- can cause visual field defects, opthalmoplegia, ptosis, and pupillary defects
- numerous endocrinopathies can result as well; most life threatening of which is acute adrenal crisis treated with hydrocortisone; monitor electrolytes closely for evidence of diabetes insipidus; evaluation and treatment of hypothyroidism and hypogonadism can be treated as inpatient
- MRI most sensitive for evaluating the pituitary; although CT and especially CT w/ IV contrast may still be helpful
Source
Lee, C. et al "Emergency Department Presentation of Pituitary Apoplexy" American Journal of Emergency Medicine. v 18. 2000 May.
