Pituitary Apoplexy

Pituitary apoplexy is acute hemorrhage or infarction of a pituitary adenoma, causing sudden expansion. Clinical: sudden severe retro-orbital headache, meningismus, visual loss, ophthalmoplegia (III/IV/VI palsies), altered mental status, and acute hypopituitarism (especially adrenal insufficiency). It is an endocrine emergency; management: urgent hydrocortisone, fluid/electrolyte management, visual assessment, and transsphenoidal decompression if visual deterioration or coma.

Common Symptoms

Sudden severe headache; visual loss; ophthalmoplegia; diplopia; altered consciousness; hypopituitarism; nausea/vomiting

Causes and Pathogenesis

Sudden hemorrhagic infarction of a pituitary adenoma expands the sella, compressing optic chiasm/cavernous sinus and destroying normal pituitary tissue.

Treatment

Immediate IV hydrocortisone; careful fluid/electrolyte/DI management; transsphenoidal decompression for visual deterioration; endocrine follow-up

Preventive Measures

Recognize sudden headache/visual change in known pituitary tumor; urgent neuroimaging.

Department to Visit

It is recommended to visit the Endocrinology department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.