Insights in Neurosurgery

Incidence and management of pituitary apoplexy among 80 patients having pituitary adenomas

4^th International Conference on BRAIN DISORDERS AND DEMENTIA CARE
August 14-16, 2017 | Toronto, Canada

Mahmoud Farid

Al Azhar University, Egypt

Keynote: Neurosurg

DOI: 10.21767/2471-9633-C1-004

Abstract

A series of 19 patients having pituitary apoplexy among 80 patients with pituitary adenomas were managed surgically and studied in our neurosurgery department within a period of four years. This study included the terms of age, sex, signs and symptoms, predisposing factors, hormonal functions, histological types of adenoma, as well as CT and MRI findings. Among these patient with pituitary apoplexy the average age was 44.9 years old, female patient constitutes 11 cases (57.9%) of the series while male patients constitutes 8 cases (42.1%). The male to female ratio was 1:1.3. Hypertension, diabetic ketoacidosis, anticoagulant therapy and huge pituitary tumor were the most predisposing factors in this study. The cardinal and important clinical manifestations was headache 16 cases (8.42%), visual disturbance 13 cases ( 6.84%), ocular movement paresis in 6 cases (31.5%), altered consciousness 1 case ( 5.2%). The preoperative hormonal study showed pituitary hypofunction is 7 cases (36.8%) and pituitary hyper function in 12 cases (63.2%). All cases of pituitary apoplexy were operated with post-operative CT and MRI brain and sella with and without contrast. The post-operative pathological findings showed 12 cases (63.2%) hemorrhagic pituitary adenoma, 5 cases (26.3%), hemorrhagic infarction and 2 cases (10.5%) pure ischemic infarction. The post-operative complication in this study showed diabetes insipidus in 6 cases (31.5%), CSF leak in 2 cases (10.5%), meningitis and death in 1 case (5.2%). Conclusion: Pituitary apoplexy is a serious event, comprises in this series 23.8% of 80 patients having pituitary adenomas. Complete recovery is possible if the diagnosis is rapidly obtained and adequate management is initiated in time, thus surgical outcome through transsphenoidal approach or endonasal approach is very satisfactory.

Biography

Mahmoud Farid Neurosurgery MD, Ph.D associate professor of Neurosurgery faculty of medicine Al Azhar University. Has completed his Ph.D of Neurological surgery at Al Azhar University, Cairo, Egypt in 2004. His specialist training involved intense study, research and teaching of both non operative and operative care and treatment of spine and brain surgery. He has authored numerous public international and national works and provides presentations on topics related to the brain and spinal lesions. Expertise in all neurological field and special interest in skull base surgery and microscopic minimal invasive spine surgery. He has experience of work in the Neurosurgery field in Gulf area from 2010 until present were cranial and spinal cases has been managed as well as the peripheral nerves lesions.