Abstract
The dramatic events surrounding pituitary apoplexy are discussed. These include the compression and malfunction of cranial nerves II, II, IV and IV, as well as endocrine issues, prostration and headache. The indications for surgery are described, in particular to highlight the need for stabilisation of the patient before any surgical intervention is even considered. Then the rationale and more particularly the timing of any surgery are described, along with the skill of the operating surgeon. Finally, the techniques for both microscope and endoscopic pituitary surgery are discussed in relation to the different texture and technique alteration required for an apoplectic pituitary adenoma.
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Abbreviations
- CSF:
-
Cerebrospinal fluid
- DI:
-
Diabetes insipidus
- SIADH:
-
Syndrome of inappropriate secretion of antidiuretic hormone
References
Cappabianca P, de Divitiisis E. Endoscopic transnasal transsphenoidal pituitary surgery. In: Powell M, Lightman S, Laws E, editors. The management of pituitary tumors, the clinicians practical guide. Totowa: Humana Press; 2003. p. 161–71.
Griffith HB, Veerapen R. A direct transnasal approach to the sphenoid sinus. Technical note. J Neurosurg. 1987;66:140–2.
Gruber A, Clayton J, Kumar S, Robertson I, Howlett TA, Mansell P. Pituitary apoplexy: retrospective review of 30 patients - is surgical intervention always necessary? Br J Neurosurg. 2006;20:379–85.
Powell M. Microscope transsphenoidal surgery. Acta Neurochir (Wien). 2012;154:913–7.
Randeva HS, Schoebel J, Byrne J, Esiri M, Adams CB, Wass JA. Classical pituitary apoplexy: clinical features, management and outcome. Clin Endocrinol (Oxf). 1999;51:181–8.
Rajasekaran S, Vanderpump M, Baldeweg S, Drake W, Reddy N, Lanyon M, Markey A, Plant G, Powell M, Sinha S, Wass J. UK guidelines for the management of pituitary apoplexy. Clin Endocrinol (Oxf). 2011;74:9–20.
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© 2014 Springer-Verlag Berlin Heidelberg
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Powell, M. (2014). Surgical Decompression for Pituitary Apoplexy. In: Turgut, M., Mahapatra, A., Powell, M., Muthukumar, N. (eds) Pituitary Apoplexy. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-38508-7_18
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DOI: https://doi.org/10.1007/978-3-642-38508-7_18
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