Outcome in pituitary apoplexy patients, stratified by delay between symptom appearance and surgery: A single center retrospective analysis
| Autor: | Abidin Murat Geyik, Ihsan Anik, Necdet Selim Kaya, Burak Cabuk, Savas Ceylan, Caner Polat, Dilek İçli |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Sphenoid Sinus medicine.medical_treatment Visual impairment Vision Disorders Single Center Time-to-Treatment Young Adult Pituitary adenoma medicine Retrospective analysis Endocrine system Humans Aged Cerebral Hemorrhage Retrospective Studies Transsphenoidal surgery Aged 80 and over Palsy business.industry Headache Pituitary apoplexy General Medicine Middle Aged medicine.disease Surgery Treatment Outcome Neuroendoscopy Female Neurology (clinical) medicine.symptom business Pituitary Apoplexy |
| Zdroj: | Clinical neurology and neurosurgery. 210 |
| ISSN: | 1872-6968 |
| Popis: | Background There are surgical and conservative management strategies in pituitary apoplexy patients. The use of both methods may lead to delayed surgery in the treatment of pituitary apoplexy. The aim of this study was to evaluate the surgical indications and outcomes of a series of patients with pituitary apoplexy according to delay between surgery and symptom onset. Methods A retrospective analysis was performed of 2711 cases with sellar pathologies treated with endoscopic transsphenoidal surgery in a single centre. Inclusion criteria were histopathological confirmation of haemorrhage or necrosis, acute onset and at least one of the following: symptoms of endocrine dysfunction; visual impairment; ophtalmoplegia; headache; or altered consciousness. Patients were divided into three groups based on the number of days from initial symptoms to surgery: early (1–7 day), delayed (8–21 days) and late (>21 day). The indication for and outcome of surgery was reviewed according to symptoms and timing of surgery. Results Ninety-one patients with pituitary apoplexy underwent surgery. The median time from ictus until surgery was 16 days (1–120 days). Headache was the most common presenting symptom. Visual impairment and ophtalmoplegia were found in 26.4% and 23.1% of patients, respectively. Surgical intervention was successful in treatment of headache in 82 (97,6%) patients. In patients in the early or delayed groups a significant improvement was found between pre- and post-operative headache, ocular palsy, visual impairment, and hormone deficiencies. Patients in the late group also had a significant improvement in headache and visual symptoms after surgery. Conclusion Surgery was sufficient in headache, endocrine, and neuro-ophthalmic outcomes at first 21 days (early and delayed groups). Beyond 21 days (late group), surgery was not effective on recovery of pituitary function. |
| Databáze: | OpenAIRE |
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