Pituitary Apoplexy

Overview
Symptoms & Diagnosis
Treatment

What is Pituitary Apoplexy?

Apoplexy is a medical term that refers to a cerebral hemorrhage or other sudden neurological impairment.

Pituitary apoplexy occurs when a pituitary adenoma either spontaneously hemorrhages or grows in such a way as to compress and cut off its own blood supply, resulting in tumor cell death, bleeding, and acute swelling.

Pituitary apoplexy complications

The hemorrhage- or necrosis-induced swelling can compress the:

Pituitary gland
Optic nerves
Nerves that control eye movement

Pituitary apoplexy is a medical emergency and can be fatal if untreated. With treatment, however, the prognosis is good.

Surgery is performed after medical stabilization. At UPMC, the preferred surgical treatment for pituitary apoplexy is the Endoscopic Endonasal Approach (EEA) to remove the tumor and decompress the area.

Diagnosing Pituitary Apoplexy

Symptoms of pituitary apoplexy

The physician will ask about symptoms, which often are sudden and severe. These may include:

Severe headache
Nausea
Vomiting
Visual loss/double vision
Loss of consciousness
Fever
Stiff neck
Hormone insufficiency

Testing to diagnose pituitary apoplexy

Pituitary apoplexy can be diagnosed by imaging studies such as head CT and MRI, along with lab studies to evaluate electrolyte, glucose, and pituitary hormone levels.

Pituitary Apoplexy Treatment

Once the person has been medically stabilized, surgery is usually a required treatment to decompress the constricted areas and remove the tumor.

Surgery

Pituitary apoplexies can be directly accessed through the Endoscopic Endonasal Approach (EEA). This approach allows doctors to:

See the pituitary gland without making an open incision
Remove and perform decompression through the nose and nasal cavities
Shorten the recovery time after treatment

The remaining pituitary gland is explored carefully to check for other lesions, and all abnormal tissue is removed.

The UPMC Pituitary Center
At the UPMC Pituitary Center, our experts use a collaborative approach to treat patients.

Endoscopic Endonasal Approach (EEA)
Pituitary Tumor Removal Using the Endoscopic Endonasal Approach (EEA) at UPMC

​Pituitary Apoplexy