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2019, Number 4

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Rev Med Inst Mex Seguro Soc 2019; 57 (4)

Pituitary apoplexy secondary to pituitary macroadenoma, a diagnostic challenge

Sánchez-Tinajero Á, Ruiz-Santillán DP

Language: Spanish
References: 25
Page: 259-263
PDF size: 264.01 Kb.


ABSTRACT

Background: Pituitary apoplexy is a clinical syndrome reflecting a rapid expansion of sellar content, typically secondary to a stroke in a previous pituitary adenoma. This pathology is a rare complication, and, therefore, underdiagnosed. The consequences of a delay in the diagnosis are translated into serious functional and even deadly complications for the patient.
Case report: We present the case of a 42-year-old male patient, who began his condition with a diffuse clinical setting, characterized by headache, amblyopia, and alterations of consciousness. The diagnosis was pituitary apoplexy, and secondary hypopituitarism, and it was treated in a conservative way, with steroid anti-inflammatories and hormonal substitution. The patient presented a psychotic episode induced by steroids, due to the supraphysiological doses used, necessary to reverse the existing neurological damage; however, it ended in a restitutio ad integrum 15 days after medical treatment, without requiring neuro-surgical intervention.
Conclusions: The clinical case presented and its resolution are clear evidence of the importance of a timely and adequate diagnosis, given that being detected in early stages, and treated early according to the evolution of the pathology, will not always require surgical intervention, allowing a total neurological restitution.


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