Hemorrhage within pituitary adenomas: how often associated with pituitary apoplexy syndrome?

Ostrov, S G; Quencer, Robert M.; Hoffman, James C.; Davis, Patricia C.; Hasso, Anton N.; David, Noble J.

doi:10.2214/ajr.153.1.153

Cited by 84 publications

(44 citation statements)

References 8 publications

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“…Meanwhile cystic areas tend to be hypointense to slightly hyperintense in MR images and increase in intensity with longer TR/TE sequences. 1 In the present cases, brain CT revealed inhomogeneous pituitary masses and hemorrhagic, necrotic, or both areas in all 4 dogs. The CT image features were similar in dogs 2 and 3: namely, poorlydefined hypoattenuating intratumoral areas and small cystic-like lesions.…”

Section: Discussionsupporting

confidence: 55%

“…16 Both techniques characterize the setting of the infarction/hemorrhage. 1 There is one reported case of pituitary apoplexy in the dog, and this condition has not been reported in other animals. 17 This study presents the clinical, imaging, and pathologic findings in 4 dogs having neurologic signs associated with pituitary infarction, hemorrhage, or both.…”

mentioning

confidence: 98%

“…This syndrome may result from sudden infarction or hemorrhage in a normal pituitary gland or, more commonly, a pituitary adenoma. [1][2][3][4] Clinical signs may progress or occur abruptly and lead to coma and death. Patients can achieve a full recovery with normal pituitary function after a bout of apoplexy or can develop hypopituitarism in cases of extensive pituitary tissue damage.…”

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confidence: 99%

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Pituitary Apoplexy-Like Disease in 4 Dogs

Bertolini¹,

Rossetti²,

Caldín³

2007

J Vet Int Med

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Section: Discussionsupporting

confidence: 55%

mentioning

confidence: 98%

mentioning

confidence: 99%

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Pituitary Apoplexy-Like Disease in 4 Dogs

Bertolini¹,

Rossetti²,

Caldín³

2007

J Vet Int Med

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“…A RMN é um método de alta resolução na detecção de hemorragia intra-selar nos estágios subagudo e crônico, enquanto a TC é mais valiosa na fase aguda da hemorragia hipofisária, principalmente nas primeiras 24-48 horas 3 . Uma vantagem adicional da RMN é que ela oferece uma estimativa da idade e tempo de curso da hemorragia 1 .…”

Section: Discussionunclassified

“…A apoplexia pituitária aguda pode caracterizar-se clinicamente por diminuição súbita da visão, paralisias oculomotoras, cefaléia severa, diminuição do nível de consciência, hipopituitarismo e sinais de irritação meníngea [1][2][3] . Isto geralmente ocorre em decorrência da expansão abrupta do conteúdo selar como resultado de hemorragia ou infarto de um adenoma pituitário ou, mais raramente, em tumores não adenomatosos e em glândulas normais 4 .…”

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Apoplexia subclínica em tumores pituitários

Pinheiro

Cukiert

Salgado

et al. 1999

Arq. Neuro-Psiquiatr.

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RESUMO -Apoplexia pituitária aguda é fenômeno relativamente raro, mesmo em macroadenomas. No entanto, a presença de áreas necro-hemorrágicas intratumorais nestes tumores que não se relacionam a qualquer sintomatologia aguda parece ser bem mais frequente do que se imaginava na era da tomografia. Com o advento da ressonância magnética estas áreas podem ser facilmente diagnosticadas pré-operatoriamente. Dentre os 40 últimos macroadenomas operados e examinados com RMN, 10 possuíam áreas apopléticas subclínicas em seu interior. Sete destes tumores eram não secretores, 2 secretores de GH e um de prolactina. O quadro clínico incluiu, além daqueles correspondentes à eventual secreção endócrina, perda visual progressiva (sem história de piora abrupta ou rápida) (n=8) e cefaléia (n=3). Após a remoção cirúrgica destes tumores e descompressão do aparato óptico, obtivemos melhora visual em 6 pacientes e em 2 a visão permaneceu inalterada. A cefaléia desapareceu em 2 casos. A presença de áreas apopléticas nestes macrotumores bem como sua ausência em séries de microtumores relatadas na literatura sugere que se relacionam mais ao tamanho do tumor do que ao seu caráter secretor ou não, o que é compatível com a provável natureza (insuficiência vascular) da apoplexia subclínica nesses casos.PALAVRAS-CHAVE: apoplexia, tumores, pituitária, assintomáticos. Asymptomatic apoplexy in pituitary tumorsABSTRACT -Acute pituitary apoplexy is a rare event, even in patients with pituitary macroadenomas. On the other hand, the presence of necrotic/hemorrhagic areas, especially in macroadenomas, seems to be more common than earlier reported in the CT period. After the introduction of MR in the presurgical workup of these patients, these apopleptic areas have been more easily diagnosed preoperatively. Forty consecutive patients with pituitary macroadenomas were studied with high-resolution 1.5 T T1 coronal, sagittal and axial slices over the sellar region. Special attention was paid in the detection of necrotic, cystic and hemorrhagic areas within these tumors. Ten patients had hemorrhagic/necrotic areas within their tumors, without any sign or symptom of acute apoplexy. These areas varied from small (2 mm) to very large (30 mm) ones. Seven patients had non-secreting tumors, 2 GH and 1 prolactin secreting tumors, which is the same profile of secretory pattern for the whole series (40 patients). The clinical picture included (other than that caused by endocrine secretion) slowly progressive (but not acute) visual loss (n=8) and headache (n=3). After surgical decompression of the surrounding structures and visual apparatus, which was facilitated by the presence of the necrotic areas, there was visual improvement in 6 patients and headache resolution in 2. The presence of asymptomatic apopleptic areas in these macroadenomas and their absence in microadenomas as can be seen in the literature suggest that they are related more to the size of the tumor than to its endocrine secretion pattern. This is in agreement with a vascular insufficiency hypothesi...

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Menstrual Disorders and Vaginal Discharge

Das

Mann

2011

Imaging of Gynecological Disorders in Infants and Children

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Hemorrhage within pituitary adenomas: how often associated with pituitary apoplexy syndrome?

Cited by 84 publications

References 8 publications

Pituitary Apoplexy-Like Disease in 4 Dogs

Pituitary Apoplexy-Like Disease in 4 Dogs

Apoplexia subclínica em tumores pituitários

Menstrual Disorders and Vaginal Discharge

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