User:Mr. Ibrahem/Pituitary apoplexy

Pituitary apoplexy is dysfunction of the pituitary gland resulting in symptoms. The most common initial symptom are headache, vomiting, and vision problems. Vision problems can include double vision, visual field loss, or decreased vision. Onset is typically sudden. Complications may include hypopituitarism, including adrenal insufficiency; or coma.

It usually occurs in the presence of a tumor of the pituitary, although most people do not realize they have the condition previously. Risk factors include high blood pressure, following surgery, pregnancy, anticoagulants, head trauma, and dengue fever. The underlying mechanism often involves either bleeding or insufficient blood supply to the pituitary. The diagnosis is suspected based on symptoms and confirmed by MRI. A lumbar puncture may find bloody cerebrospinal fluid.

Initial treatment typically involves intravenous normal saline together with 100 mg of hydrocortisone. Surgical decompression is recommended within 7 days in people with vision problems or a decreased level of consciousness. About 80% of people have long-term hypopituitarism and thus require ongoing hormone replacement.

Pituitary apoplexy is uncommon, affecting about 0.4% of the population. In those with pituitary tumors up to 10% are affected. The first case was documented in 1898 by Pearce Bailey. The current name came into use in 1950.