Pituitary apoplexy (patient information): Difference between revisions
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==What are the symptoms?== | ==What are the symptoms?== | ||
Pituitary infarction usually has a short period of symptoms (acute), but it can be life-threatening. | [[Pituitary gland|Pituitary]] [[infarction]] usually has a short period of [[symptoms]] (acute), but it can be life-threatening. | ||
Symptoms usually include: | Symptoms usually include: | ||
*Severe [[headache]] | *Severe [[headache]] | ||
*Paralysis of the eye muscles | *[[Paralysis]] of the [[Eye muscles|eye muscles (]][[ophthalmoplegia]]) causing [[Diplopia|double vision]] | ||
*Low [[blood pressure]], [[nausea]], and [[vomit]]ing from [[ | *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 a lack of the hormone [[prolactin]]. | Less commonly, [[Pituitary gland|pituitary]] dysfunction may appear more slowly. In [[Sheehan syndrome]], for example, the first [[symptom]] may be a failure to produce [[milk]] caused by a 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 gland|pituitary]] [[hormones]] may develop, causing [[symptoms]] of the following conditions: | ||
*[[Growth hormone]] deficiency | *[[Growth hormone]] deficiency | ||
**[[Fatigue]] | **[[Fatigue]] | ||
**Increased fat in the abdomen | **Increased [[fat]] in the [[abdomen]] | ||
**Lack of energy | **Lack of energy | ||
*[[Hypoadrenalism]] (if not already present or treated) | *[[Hypoadrenalism]] (if not already present or treated) | ||
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**Hair or skin changes | **Hair or skin changes | ||
**[[Hoarseness]] | **[[Hoarseness]] | ||
**Menstrual changes | **[[Menstrual cycle|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]] | ||
==What are the causes?== | ==What are the causes?== | ||
Pituitary infarction is most commonly caused by bleeding due to a noncancerous tumor of the pituitary. When this bleeding occurs in a woman during or immediately after childbirth, it is called [[Sheehan syndrome]]. | [[Pituitary gland|Pituitary]] [[infarction]] is most commonly caused by [[bleeding]] due to a noncancerous [[tumor]] of the [[Pituitary gland|pituitary]]. When this [[bleeding]] occurs in a woman during or immediately after [[childbirth]], it is called [[Sheehan syndrome]]. | ||
==Who is at highest risk?== | ==Who is at highest risk?== | ||
Risk factors for pituitary infarction include: | Risk factors for [[Pituitary gland|pituitary]] [[infarction]] include: | ||
*Bleeding disorders | *[[Bleeding disorders]] | ||
*[[Diabetes]] | *[[Diabetes]] | ||
*Head injury | *[[Head injury]] | ||
*Radiation to the pituitary gland | *[[Radiation therapy|Radiation]] to the [[pituitary gland]] | ||
*Use of a breathing machine | *Use of a breathing machine | ||
==When to seek urgent medical care?== | ==When to seek urgent medical care?== | ||
Call your health care provider if you have any symptoms of chronic pituitary insufficiency. | Call your [[health]] care provider if you have any [[symptoms]] of chronic [[pituitary insufficiency]]. | ||
Go to the emergency room or call the local emergency number (such as 911) if you have symptoms of acute pituitary infarction, including: | Go to the [[emergency room]] or call the local emergency number (such as [[911]]) if you have [[symptoms]] of acute [[Pituitary gland|pituitary]] [[infarction]], including: | ||
*Eye weakness | *Eye weakness | ||
*[[Headache (patient information)|Headache]] | *[[Headache (patient information)|Headache]] | ||
*Low blood pressure (which can cause fainting) | *[[Low blood pressure]] (which can cause fainting) | ||
*[[Nausea]] | *[[Nausea]] | ||
*[[Vomiting]] | *[[Vomiting]] | ||
Be especially concerned if you develop these symptoms and you have already been diagnosed with a pituitary tumor. | Be especially concerned if you develop these [[symptoms]] and you have already been diagnosed with a [[pituitary tumor]]. | ||
==Diagnosis== | ==Diagnosis== | ||
Signs of acute pituitary infarction may include: | Signs of [[Acute (medicine)|acute]] [[Pituitary gland|pituitary]] [[infarction]] may include: | ||
*Low blood pressure | *[[Low blood pressure]] | ||
*Visual field defects | *[[Visual field defect|Visual field defects]] | ||
Signs of chronic pituitary insufficiency include: | Signs of chronic [[pituitary insufficiency]] include: | ||
*Growth hormone deficiency | *[[Growth hormone]] [[deficiency]] | ||
**Loss of muscle mass | **Loss of [[muscle mass]] | ||
**Problems with fat metabolism (dyslipidemia) | **Problems with fat metabolism ([[dyslipidemia]]) | ||
*[[Adrenal insufficiency (patient information)|Hypoadrenalism]] | *[[Adrenal insufficiency (patient information)|Hypoadrenalism]] | ||
**Low blood pressure | **[[Low blood pressure]] | ||
**Poor response to stress and infection | **Poor response to [[Stress (medicine)|stress]] and [[infection]] | ||
*[[Hypothyroidism (patient information)|Hypothyroidism]] | *[[Hypothyroidism (patient information)|Hypothyroidism]] | ||
**Delayed reflexes | **Delayed [[reflexes]] | ||
Tests may include: | Tests may include: | ||
*Bone density test | *[[Bone density]] test | ||
*Eye exams | *Eye exams | ||
*MRI or CT scan | *[[MRI]] or [[CT]] scan | ||
Blood tests will be done to check levels of: | Blood tests will be done to check levels of: | ||
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*[[LH]] | *[[LH]] | ||
*[[Prolactin]] | *[[Prolactin]] | ||
*Somatomedin C (IGF-1) | *Somatomedin C ([[IGF-1]]) | ||
==Treatment options== | ==Treatment options== | ||
Treatment for acute infarction may require surgery to relieve pressure on the pituitary and improve vision symptoms. Severe cases need emergency surgery. | Treatment for acute [[infarction]] may require [[surgery]] to relieve [[pressure]] on the [[Pituitary gland|pituitary]] and improve [[vision]] [[symptoms]]. Severe cases need emergency surgery. | ||
Immediate treatment with adrenal replacement hormones (glucocorticoids) is essential. Other hormones will be replaced, including: | Immediate treatment with adrenal replacement hormones (glucocorticoids) is essential. Other hormones will be replaced, including: | ||
*Sex hormones ([[estrogen]]/[[testosterone]]) | *[[Sex hormones]] ([[estrogen]]/[[testosterone]]) | ||
*[[Thyroid hormone]] | *[[Thyroid hormone]] | ||
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==What to expect (Outlook/Prognosis)?== | ==What to expect (Outlook/Prognosis)?== | ||
Acute pituitary infarction can be life-threatening. The outlook is good for people who have chronic deficiency that is diagnosed and treated. | [[Acute (medicine)|Acute]] [[Pituitary gland|pituitary]] [[infarction]] can be life-threatening. The outlook is good for people who have chronic [[deficiency]] that is diagnosed and treated. | ||
==Possible complications== | ==Possible complications== | ||
Complications of untreated pituitary infarction can include: | Complications of untreated [[Pituitary gland|pituitary]] [[infarction]] can include: | ||
*[[Adrenal crisis]] | *[[Adrenal crisis]] | ||
*[[Vision loss]] | *[[Vision loss]] | ||
If other missing hormones are not replaced, you may develop problems related to [[hypothyroidism]] and [[hypogonadism]]. | If other missing [[hormones]] are not replaced, you may develop problems related to [[hypothyroidism]] and [[hypogonadism]]. | ||
==Sources== | ==Sources== | ||
Revision as of 20:29, 27 July 2017
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Pituitary apoplexy |
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Pituitary apoplexy On the Web |
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For the WikiDoc page for this topic, click here
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Varun Kumar M.B.B.S.; Ogheneochuko Ajari, MB.BS, MS [2] Akshun Kalia M.B.B.S.[3]
Overview
Pituitary infarction is the death of an area of tissue in the pituitary gland, a small gland joined to the hypothalamus (part of the brain). The pituitary produces many of the hormones that control essential body processes.
What are the symptoms?
Pituitary infarction usually has a short period of symptoms (acute), but it can be life-threatening.
Symptoms usually include:
- Severe headache
- Paralysis of the eye muscles (ophthalmoplegia) causing double vision
- 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 a lack of the hormone prolactin.
Over time, problems with other pituitary hormones may develop, causing symptoms of the following conditions:
- Growth hormone deficiency
- 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
What are the causes?
Pituitary infarction is most commonly caused by bleeding due to a noncancerous tumor of the pituitary. When this bleeding occurs in a woman during or immediately after childbirth, it is called Sheehan syndrome.
Who is at highest risk?
Risk factors for pituitary infarction include:
- Bleeding disorders
- Diabetes
- Head injury
- Radiation to the pituitary gland
- Use of a breathing machine
When to seek urgent medical care?
Call your health care provider if you have any symptoms of chronic pituitary insufficiency.
Go to the emergency room or call the local emergency number (such as 911) if you have symptoms of acute pituitary infarction, including:
- Eye weakness
- Headache
- Low blood pressure (which can cause fainting)
- Nausea
- Vomiting
Be especially concerned if you develop these symptoms and you have already been diagnosed with a pituitary tumor.
Diagnosis
Signs of acute pituitary infarction may include:
Signs of chronic pituitary insufficiency include:
- Growth hormone deficiency
- Loss of muscle mass
- Problems with fat metabolism (dyslipidemia)
- Hypoadrenalism
- Low blood pressure
- Poor response to stress and infection
- Hypothyroidism
- Delayed reflexes
Tests may include:
- Bone density test
- Eye exams
- MRI or CT scan
Blood tests will be done to check levels of:
- ACTH
- Cholesterol
- Cortisol
- FSH
- Growth hormone
- LH
- Prolactin
- Somatomedin C (IGF-1)
Treatment options
Treatment for acute infarction may require surgery to relieve pressure on the pituitary and improve vision symptoms. Severe cases need emergency surgery.
Immediate treatment with adrenal replacement hormones (glucocorticoids) is essential. Other hormones will be replaced, including:
Evidence is also growing for the need to replace growth hormone.
Where to find medical care for Pituitary apoplexy?
Directions to Hospitals Treating Pituitary apoplexy
What to expect (Outlook/Prognosis)?
Acute pituitary infarction can be life-threatening. The outlook is good for people who have chronic deficiency that is diagnosed and treated.
Possible complications
Complications of untreated pituitary infarction can include:
If other missing hormones are not replaced, you may develop problems related to hypothyroidism and hypogonadism.