What Causes Pituitary Apoplexy?

Pituitary apoplexy is an emergent medical event where a patient experiences infarction or hemorrhage in their pituitary gland. Symptoms of pituitary apoplexy include altered consciousness, vomiting, headache, facial pain, fever, loss of body and facial hair, infertility, appetite loss, weight loss, weight gain, fatigue, dizziness, seizures, visual defect, altered sensorium, neck stiffness, and endocrine dysfunction. Most symptoms are related to hormonal abnormalities caused by hemorrhage or infarction. 

Diagnosis of pituitary apoplexy is made with the use of MRI scans, testing of hormone levels, and vision testing. Treatment of an individual affected by pituitary apoplexy includes the high-dose corticosteroid administered at a rapid rate, diligent monitoring of electrolyte and fluid levels, and emergency transsphenoidal surgery.

Pituitary Adenoma

A pituitary adenoma is a noncancerous growth or tumor that develops in the pituitary gland. A pituitary adenoma may or may not produce an excessive amount of certain hormones. Although most pituitary adenomas are slow-growing, they can grow to a large size without causing patients to experience noticeable symptoms. A pituitary adenoma can cause pituitary apoplexy through one of two mechanisms. The first mechanism is associated with the damage and bursting of blood vessels in and around the tumor, producing a significant bleed. The blood from this bleed puts too much pressure on the tissues of the pituitary gland, producing the symptoms of pituitary apoplexy. 

Another mechanism where a pituitary adenoma can cause a patient to have pituitary apoplexy involves the pituitary adenoma growing large enough to cause the death of a significant amount of tissue in the pituitary gland. This mechanism also produces a significant amount of pressure on and around the functional tissue of the pituitary gland.