UpToDate: Pituitary apoplexy outcome

Pituitary apoplexy outcome

The visual acuity outcome after pituitary apoplexy appears to be better in early intervention as compared to late. Nevertheless, good visual recovery is also seen in late surgical intervention 1).

The timing of surgical intervention relative to the onset of symptoms does not appear to significantly affect the resolution of neurological or endocrinological deficits 2).

The outcome of most patients with pituitary apoplexy is excellent. Selected patients can be managed conservatively, and patients with severe neuro-ophthalmological deficits treated with early surgery can achieve an excellent recovery 3).

Normal and high preoperative PRL levels are associated with better endocrine outcome after surgery. The patients benefit from surgical intervention even after delayed diagnosis with the serum PRL levels is being a valid biomarker for clinical decision making 4).

References

1)

Abdulbaki A, Kanaan I. The impact of surgical timing on visual outcome in pituitary apoplexy: Literature review and case illustration. Surg Neurol Int. 2017 Feb 6;8:16. doi: 10.4103/2152-7806.199557. eCollection 2017. Review. PubMed PMID: 28217395; PubMed Central PMCID: PMC5309450.

2)

Rutkowski MJ, Kunwar S, Blevins L, Aghi MK. Surgical intervention for pituitary apoplexy: an analysis of functional outcomes. J Neurosurg. 2017 Sep 15:1-8. doi: 10.3171/2017.2.JNS1784. [Epub ahead of print] PubMed PMID: 28946177.

3)

Singh TD, Valizadeh N, Meyer FB, Atkinson JL, Erickson D, Rabinstein AA. Management and outcomes of pituitary apoplexy. J Neurosurg. 2015 Jun;122(6):1450-7. doi: 10.3171/2014.10.JNS141204. Epub 2015 Apr 10. PubMed PMID: 25859804.

4)

Lammert A, Walter MS, Giordano FA, Al Zhgloul M, Krämer BK, Nittka S, Schulte DM, Ratliff M, Hänggi D, Seiz-Rosenhagen M. Neuro-Endocrine Recovery After Pituitary Apoplexy: Prolactin as a Predictive Factor. Exp Clin Endocrinol Diabetes. 2018 Jul 2. doi: 10.1055/a-0640-2915. [Epub ahead of print] PubMed PMID: 29966153.

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