Friday, December 24, 2010

UK guidelines for the management of pituitary apoplexy

Authors: Rajasekaran, Senthil1; Vanderpump, Mark2; Baldeweg, Stephanie3; Drake, Will4; Reddy, Narendra1; Lanyon, Marian5; Markey, Andrew6; Plant, Gordon5; Powell, Michael7; Sinha, Saurabh8; Wass, John9

Source: Clinical Endocrinology, Volume 74, Number 1, January 2011 , pp. 9-20(12)

Publisher: Wiley-Blackwell

Abstract:

Summary

Classical pituitary apoplexy is a medical emergency and rapid replacement with hydrocortisone maybe life saving. It is a clinical syndrome characterized by the sudden onset of headache, vomiting, visual impairment and decreased consciousness caused by haemorrhage and/or infarction of the pituitary gland. It is associated with the sudden onset of headache accompanied or not by neurological symptoms involving the second, third, fourth and sixth cranial nerves. If diagnosed patients should be referred to a multidisciplinary team comprising, amongst others, a neurosurgeon and an endocrinologist. Apart from patients with worsening neurological symptoms in whom surgery is indicated, it is unclear currently for the majority of patients whether conservative or surgical management carries the best outcome. Post apoplexy, there needs to be careful monitoring for recurrence of tumour growth. It is suggested that further trials be carried out into the management of pituitary apoplexy to optimize treatment.

Document Type: Research article

DOI: 10.1111/j.1365-2265.2010.03913.x

Affiliations: 1: Churchill Hospital, Oxford 2: Royal Free Hospital, London 3: University College Hospital, London and Trustee and member of the Medical Committee -The Pituitary Foundation 4: St. Bartholomew's Hospital, London and Society for Endocrinology 5: University College Hospital, London 6: The Lister Hospital, London 7: National Hospital for Neurology, London and Society of British Neurosurgeons 8: Royal Hallamshire Hospital, Sheffield 9: Churchill Hospital, Oxford and Royal College of Physicians

From http://www.ingentaconnect.com/content/bsc/cend/2011/00000074/00000001/art00002