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Type: Journal article
Title: Neuro-ophthalmic manifestations and outcomes of pituitary apoplexy - a life and sight-threatening emergency
Author: Simon, S.
Torpy, D.
Brophy, B.
Blumbergs, P.
Selva-Nayagam, D.
Crompton, J.
Citation: New Zealand Medical Journal, 2011; 124(1335):52-59
Publisher: Southern Colour Print
Issue Date: 2011
ISSN: 1175-8716
Statement of
Sumu Simon, David Torpy, Brian Brophy, Peter Blumbergs, Dinesh Selva, John L Crompton
Abstract: Objective: To report the neuro-ophthalmic manifestations and outcomes in patients with pituitary apoplexy. Method Retrospective chart review. Results: 23 patients were identified (17 men, mean age 54.1 years (range 23–86 years). The onset was abrupt in 22 patients; one patient had a subclinical presentation. Headache was the commonest presenting symptom (82.6%, 19/23). Neuro-ophthalmic manifestations were present in more than three-quarters of the patients (82.6%, 19/23). At presentation, 55 % (11/20), 47.6 % (10/21) and 60.9 % (14/23) of the patients had reduced visual acuity, field defects and cranial nerve palsies respectively. Management was conservative in 4 patients and surgical in 18 patients; one patient died shortly after presentation. The median follow up period was 10.5 months (22 patients, range 0.2–168 months). At final follow up, improvement was present in 100% of the patients with reduced acuity (8/8) and ocular palsy (13/13) and 81.8% of patients with field deficits (9/11). Age, sex, presence of precipitating factors and timing of surgery did not have an impact on neuro-ophthalmic recovery. Conclusion: Pituitary apoplexy should be considered in any patient with abrupt onset of neuro-ophthalmic deficits. Prompt medical and surgical management is lifesaving and can lead to significant improvement in visual and cranial nerve deficits.
Keywords: Humans
Pituitary Neoplasms
Brain Ischemia
Cerebral Infarction
Cerebral Hemorrhage
Pituitary Apoplexy
Cranial Nerve Diseases
Vision Disorders
Diagnostic Errors
Retrospective Studies
Follow-Up Studies
Visual Acuity
Visual Fields
Aged, 80 and over
Middle Aged
Young Adult
Rights: © NZMA
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Appears in Collections:Aurora harvest 5
Opthalmology & Visual Sciences publications

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