Apoplexia hipofisária secundária a adenoma hipofisário: Revisão

摘要: Pituitary apoplexy is an endocrine emergency that may occur due to ischemia or hemorrhage of the pituitary gland. In most cases, it is the first manifestation of an underlying pituitary tumor, especially pituitary adenoma, functional or nonfunctional. It is a condition with many clinical presentations, including some asymptomatic patients. The most common symptoms are headache, nausea and vomiting, deterioration of visual acuity, visual field defects, ophthalmoplegia, altered state of consciousness, and meningeal signs. Some risk factors have been associated with pituitary apoplexy, including the use of vitamin K inhibitors or platelet inhibitors, diabetes mellitus, radiation, trauma, dynamic tests of pituitary function, hypertension, among others. The treatment of pituitary apoplexy in the acute stage is controversial because its course is unpredictable. Most cases have been treated surgically and, unless surgery is delayed, surgical decompression results are satisfactory. Conservative therapy involves supportive therapy, with continuous use of high doses of corticosteroids for several weeks, hormone replacement, and clinical and laboratory control. Patient follow-up after treatment is necessary. The prognosis is good in most patients. The level of visual recovery is related to the elapsed time from diagnosis to decompression, and to the initial degree of impairment.