Conservative Management of Pituitary Apoplexy


Author (years)

Ayuk et al. (2004)

Gruber et al. (2006)

Sibal et al. (2004)

Type of management

Conservative

Surgery

P

Conservative

Surgery

P

Conservative

Surgery

P

N

18

15


20

10


18

27


Mean age (year) (range)

NA

NA


54 (23–84)

46 (17–70)


45.7 (25–72)

50.7 (25–72)

NS

Male/female

NA

NA


16/4

7/3


9/9

19/8
 
At presentation

Number (%) with decreased visual acuity

NA

NA


11 (55)

7 (70)


4/15 (26)

14/24 (58)

0.01

Number (%) with visual field defect

6 (33)

7 (46)

ns

4 (20)

6 (60)


4/17 (24)

16/25 (64)

0.01

Number (%) with ocular palsy

7 (39)

8 (53)

ns

12 (60)

3 (37)


8/17 (47)

14/26 (54)

NS

Number (%) with hypopituitarism

13 (87)

15 (83)

ns

15 (75)

9 (90)


13/18 (72)

21/24 (87)

NS

Outcome

Decreased visual acuity

Complete resolution

NA

NA


5/11 (45)

4/7 (57)


3/4 (75)

8/14 (57)


Partial/near-complete resolution

NA

NA


4/11 (36)

2/7 (28)


1/4 (25)

5/14 (36)


No improvement

NA

NA


2/11 (19)

1/7 (15)


0

1/14 (7)


Visual field defect

Complete resolution

6/6 (100)

4/7 (57)

ns

2/4 (50)

2/6 (33)


3/4 (75)

7/16 (43)


Partial/near-complete resolution

0

NA


1/4 (25)

3/6 (50)


1/4 (25)

8/16 (50)


No improvement

0

NA


1/4 (25)

1/6 (17)


0

1/16 (7)


Ocular palsy

Complete

7/7 (100)

5/8 (63)

ns

10/12 (83)

2/3 (66)


6/8 (75)

9/14 (64)


Partial/near-complete resolution

0

NA


2/12 (17)

1/3 (33)


2/8 (25)

4/14 (29)


No improvement

0

NA


0

0


0

1/14 (7)


Endocrine impairment

Normal function

NA

NA


1 (5)

2 (20)


2 (11)

5 (19)


Corticotropic deficiency

13/18 (72)

13/15 (87)

ns

(68)

(60)


NA

NA


Thyrotropic deficiency

9/15 (60)

13/15 (87)

ns

(70)

(68)


NA

NA


Gonadotropic deficiency

15/18 (83)

10/15 (67)

ns

(80)

(86)


NA

NA


Tumor growth

Recurrence of pituitary adenoma

1 (5)

1 (6)


0

6 (60)


4 (22)

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Sep 26, 2017 | Posted by in GENERAL & FAMILY MEDICINE | Comments Off on Conservative Management of Pituitary Apoplexy

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