Acute Hemorrhagic Apoplectic Pituitary Adenoma: Endoscopic Management, Surgical Outcomes, and Complications

The Journal of Craniofacial Surgery
Rucai ZhanXingang Li

Abstract

To assess safety and effectiveness of endoscopic transsphenoidal surgery (ETS) for acute hemorrhagic apoplectic pituitary adenoma. Eighty nine patients with hemorrhagic apoplectic pituitary tumor undergoing endoscopic transsphenoidal surgery were included into a retrospective chart of this study. Charts were reviewed for patient age, sex, presentation, lesion size, surgical procedure, extent of resection, clinical outcome, and surgical complications. Seventy eight (87.7%) patients achieved total resection, 9 (10.1%) had subtotal resection, and 2 (2.2%) patients had partial resection; no patient experienced insufficient resection. After surgery, 65 (90.3%) of 72 patients who had visual acuity deterioration preoperatively normalized and improved significantly; the rate for remission of visual field was 87.7%. All other acute symptoms, such as severe headache, nausea, vomiting, alteration of mental status, and loss of consciousness, vanished postoperatively. Twenty eight (90.4%) of 31 patients with active secreting adenoma had hormonal remission based on endocrinological evaluation. Three (3.4%) patients incurred CSF leakage which was managed with lumbar drainage. Nine (10.1%) patients incurred transient DI postoperatively, and 2 ...Continue Reading

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