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Abstract
Background
Reports on pituitary apoplexy in Korea are limited. There are two treatment options for pituitary apoplexy - surgical decompression and conservative management. In this study, we examined clinical presentation and outcomes following different therapies in Korean patients with pituitary apoplexy.
Methods
Clinical data and treatment outcomes from 52 patients with pituitary apoplexy who visited Seoul National University Hospital between January 1992 and June 2008 were reviewed retrospectively. Patients were divided into 2 groups according to management options (a surgery group vs. a conservative management group) and their outcomes were compared. For patients who underwent surgery due to neurological symptoms, outcomes were compared between early and late surgery groups.
Results
Headache (73.1%) was the most common presenting symptom, and more than half of the patients were reported to have visual symptoms. The most common type of pathology was a nonfunctioning pituitary adenoma (67.3%). Nine patients received conservative management and 43 underwent surgical decompression. Their recovery from neurological and endocrinological abnormalities were similar. Among patients who showed neurological symptoms, 9 underwent surgery within 1 week of symptom onset and 24 underwent surgery after 1 week. There was no significant difference between outcomes of early and late surgery groups except recovery from impaired visual deficit was greater in the late surgery group.
Figures and Tables
Table 2
Comparisons of outcomes in the surgery and conservative treatment group
*Data were analyzed from 28 patients who initially reported impaired visual acuity.
†Data were analyzed from 26 patients who initially reported impaired visual field.
‡Data were analyzed from 13 patients who initially reported ophthalmoplegia.
§Data from 47 patients were available (40 from surgery group and 7 from conservative treatment group).
Table 4
Comparisons of patients with neurologic symptoms between early and late surgery group
*Early surgery group have treated within 1 week of presentation, on the other hand, late surgery group have treated after 1 week.
†Data from 26 of 33 patients were available (8 from early surgery group and 18 from late surgery group, respectively).
‡Data were analyzed from 24 patients who initially reported impaired visual acuity.
§Data were analyzed from 18 patients who initially reported impaired visual field.
∥Data were analyzed from 6 patients who initially reported ophthalmoplegia.
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