Surgical Decompression for Pituitary Apoplexy
Fig. 18.1 (a–f) MRI sequence: (a axial T1, b coronal T1, c coronal enhanced T1 and d sagittal T1) of a 40-year-old woman presenting with classical apoplexy, who suffered sudden…
Fig. 18.1 (a–f) MRI sequence: (a axial T1, b coronal T1, c coronal enhanced T1 and d sagittal T1) of a 40-year-old woman presenting with classical apoplexy, who suffered sudden…
Fig. 14.1 (a) CT scan shows hemorrhagic PA extending locally to the suprasellar cisterns. (b) Postoperative CT scan after pituitary removal When SAH is secondary to a preexisting intracranial aneurysm,…
Fig. 16.1 An illustrative case of haemorrhagic RCC (Komatsu et al. 2010). A 46-year-old man had a 4-day history of severe headache. Neurological and endocrinological findings were normal. Coronal MR…
Fig. 9.1 Sagittal section of contrast-enhanced MRI scan showing apoplexy within pituitary tumour 9.2 Pathophysiology Pathophysiology of vasospasm following pituitary apoplexy remains unknown. Trans-diaphragmatic rupture of the sellar tumour into…
Symptoms or signs Percentage of patients Headache Up to 100 % Nausea and vomiting 40–70 % Meningeal irritation 25 % Photophobia 33 % Mental deterioration 20 % Ocular paresis (diplopia…
Fig. 10.1 Anatomy of the pituitary fossa and cavernous sinus (Adapted with kind permission from Gray (1918); Bartleby.com, 2000. www.bartleby.com/107) 10.4 Neuro-ophthalmological Signs in Acute Pituitary Apoplexy The literature describing…
Fig. 20.1 Preoperative Contrast MRI of the Brain reveal a sellar surprasellar mass lesion with significant subfrontal extension Lowerate bulging into Sphenoid Sinus: (a) Axial, (b, c) Sagittal and (d)…
Fig. 15.1 Enhanced CT scan on axial view (a) and sagittal T2-weighted MRI (b) showing a bilateral hypothalamic lymphoma with suprasellar extension, optic chiasm infiltration and brainstem involvement Fig. 15.2…
Precipitating factors in pituitary apoplexy Head trauma Major surgery – especially coronary artery bypass surgery, but also aortic abdominal aneurysm surgery, cholecystectomy, shoulder arthroplasty and others Hypotension Hypertension Pregnancy Oestrogen…
Mehmet Turgut, Ashok Kumar Mahapatra, Michael Powell and Natarajan Muthukumar (eds.)Pituitary Apoplexy201410.1007/978-3-642-38508-7_19 © Springer-Verlag Berlin Heidelberg 2014 19. Timing of Surgery and Outcome in Pituitary Apoplexy Natarajan Muthukumar1 (1) Department of Neurosurgery, Madurai Medical College, Muruganagam, 138, Anna…