Ischemic Infarction of Pituitary Apoplexy: A Retrospective Study of 46 Cases From a Single Tertiary Center

• DOI: 10.3389/fnins.2021.808111
• Publication Date: 2022-01-24T06:15:41Z
• Authors: Qiang Zhu; Yuchao Liang; Ziwen Fan; Yukun Liu; Chunyao Zhou; Hong Zhang; Tianshi Li; Yanpeng Zhou; Jianing Yang; Yinyan Wang; Lei Wang
• Keywords: Pituitary apoplexy; Histopathology; Transsphenoidal surgery; Single Center

Objective Ischemic infarction of pituitary apoplexy (PA) is a rare type apoplexy. This study aims to characterize ischemic PA via clinical presentations, imaging data, histopathological manifestations, and focus on the management prognosis disease. Methods retrospectively identified 46 patients with confirmed using histopathology at single institution from January 2013 December 2020. The laboratory examination, management, outcomes were collected. We then summarized features, intraoperative findings, compared based timing surgical intervention. Results Headache was most common initial symptom (95.65%, 44/46), followed by visual disturbance (89.13%, 41/46), nausea vomiting (58.70%, 27/46). 91.3% had least one dysfunction, hypogonadism being endocrine dysfunction (84.78%, 39/46). Cortisol occurred in 24 (52.17%) thyroid 17 (36.96%). Typical rim enhancement thickening sphenoid sinus MRI seen 35 (85.37%) 26 (56.52%) patients, respectively. Except for patient asymptomatic apoplexy, remaining underwent early (≤ 1 week, 12 patients) delayed (> 33 transsphenoidal surgery. Total tumor resection achieved 27 subtotal 19 patients. At surgery, cottage cheese–like necrosis observed 50% (23/46) last follow-up 5.5 ± 2.7 years, 92.68% (38/41) gained significant improvement regardless timing, 65% still receiving long-term hormone replacement therapy. Conclusion Patients can be accurately diagnosed typical characteristics preoperatively. intervention does not significantly affect resolution neurological endocrinological dysfunctions. Preoperative dysfunctions are usually appear poor after