Pituitary apoplexy (patient information): Difference between revisions

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Symptoms usually include:
Symptoms usually include:


*Severe headache
*Severe [[headache]]
*Paralysis of the eye muscles, causing double vision (ophthalmoplegia)
*Paralysis of the eye muscles, causing double vision ([[ophthalmoplegia]])
*Low blood pressure, nausea, and vomiting 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 a 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 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 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)
**Inability to deal with physical stress
**Inability to deal with physical 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
**Constipation
**[[Constipation]]
**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 18:38, 5 April 2013

Pituitary apoplexy

Overview

What are the symptoms?

What are the causes?

Who is at highest risk?

When to seek urgent medical care?

Diagnosis

Treatment options

Where to find medical care for Pituitary apoplexy?

What to expect (Outlook/Prognosis)?

Possible complications

Pituitary apoplexy On the Web

Ongoing Trials at Clinical Trials.gov

Images of Pituitary apoplexy

Videos on Pituitary apoplexy

FDA on Pituitary apoplexy

CDC on Pituitary apoplexy

Pituitary apoplexy in the news

Blogs on Pituitary apoplexy

Directions to Hospitals Treating Pituitary apoplexy

Risk calculators and risk factors for Pituitary apoplexy

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]

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:

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:

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:

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:

  • Low blood pressure
  • Visual field defects

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:

  • Sex hormones (estrogen/testosterone)
  • Thyroid hormone

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.

Sources

http://www.nlm.nih.gov/medlineplus/ency/article/001167.htm

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