Hypophysis apoplexy
Contents:
Description:
Hypophysis apoplexy — the rare state caused by sudden increase in the size of a tumor of a hypophysis because of hemorrhage.
Gipotalamo-gipofizarnaya system
Hypophysis Apoplexy symptoms:
The acute hemorrhagic heart attack of pituitary adenoma serves as the reason of bystry development of the syndrome including an acute headache, nausea, vomiting and stupefaction. Also the ophthalmoplegia, vision disorders and reactions of a pupil and the meningeal phenomena are noted. The majority of these symptoms is caused by the direct pressure of hemorrhage in a tumor, and the meningeal phenomena are connected with hit of blood in SMZh. The syndrome or develops for 24 — 48 h, or leads to sudden death.
Hypophysis Apoplexy reasons:
The hypophysis apoplexy most often arises at patients with the known somatotropic or corticotropic adenomas, but maybe the first clinical display of a tumor of a hypophysis. Contribute to a hemorrhagic heart attack anti-coagulative and radiation therapy. In rare instances the apoplexy of a hypophysis causes an autogipofizektomiya with disappearance of clinical symptoms of an acromegalia, Cushing's disease or a giperprolaktinemiya (some kind of treatment). The hypopituitarism is a frequent consequence; though in an acute phase of a syndrome at single determination of level of hormones results can be normal, concentration of cortisol and sexual steroids decreases in the next few days, and for several weeks also thyroxine level decreases. In rare instances not diabetes mellitus develops.
Treatment of the Apoplexy of a hypophysis:
Function of a hypophysis is with firmness broken, bystry purpose of corticosteroids and endocrinological assessment is required.
The Bystry decompression is shown in the following cases: sudden narrowing of fields of vision, sharp and/or bystry decrease in visual acuity, the neurologic deterioration caused by GTsF. The decompression is usually carried out transsphenoidal access though in certain cases transcranial access can have advantages. Operation purposes:
1. a decompression of the following structures if they are under supertension: visual pathways, hypophysis, cavernous sine, Sh-y ventricle (elimination of GTsF)
2. receiving material for a histologic research
3. the full oncotomy usually is not required
4. at GTsF: usually installation of a ventrikulyarny drainage is required
