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Alternative names Return to top
Pituitary apoplexyDefinition Return to top
Pituitary infarction is the death of an area of tissue in the pituitary gland, a small gland joined to the hypothalamus (part of the brain). The pituitary produces many of the hormones that control essential body processes.
Causes, incidence, and risk factors Return to top
Pituitary infarction is most commonly caused by bleeding into a benign tumor of the pituitary, which kills an area of tissue in the pituitary gland. When this bleeding occurs in a woman during or immediately after childbirth, it is called Sheehan's syndrome.
Risk factors for pituitary infarction include diabetes, bleeding disorders, head trauma, pituitary radiation, and use of a breathing machine. However, in most cases, the cause is not clear.
Pituitary infarction is usually acute (short period of symptoms) and can be life-threatening.
Symptoms Return to top
Symptoms are usually acute and include severe headache, ophthalmoplegia (paralysis of the eye muscles causing double vision), and symptoms of acute adrenal insufficiency (low blood pressure, nausea, and vomiting).
Less commonly, pituitary dysfunction may appear more slowly. In Sheehan's syndrome, for example, the initial symptom may be a failure to produce milk caused by a lack of the hormone prolactin.
Over time, insufficiency in other pituitary hormones may develop, causing symptoms of the following conditions:
When the posterior pituitary is involved (rare), there may be uncontrolled urination.
Signs and tests Return to top
Signs of acute infarction may include ophthalmoplegia, visual field defects, and hypotension (low blood pressure).
Signs of chronic pituitary insufficiency include:
Tests may include:
Treatment Return to top
Treatment for acute infarction may require surgery to decompress the area of the pituitary and improve visual symptoms. Severe cases constitute a surgical emergency. Immediate treatment with adrenal replacement hormones (glucocorticoids) is essential.
Replacement of other missing hormones is also required, including sex hormones (estrogen/testosterone) and thyroid hormone. Evidence is growing for the need for growth hormone replacement.
Expectations (prognosis) Return to top
Acute pituitary infarction is a potentially life-threatening event. Prognosis for chronic deficiency (which is detected and treated) is good.Complications Return to top
Complications of untreated pituitary infarction can include visual loss and adrenal crisis. If other deficient hormones are not replaced, problems related to hypothyroidism and hypogonadism may develop.Calling your health care provider Return to top
Call your health care provider if you have any signs or symptoms of chronic pituitary insufficiency.
Go to the emergency room or call the local emergency number (such as 911) if you have symptoms of acute pituitary infarction, including headache, eye weakness, low blood pressure (which can cause fainting), nausea, and vomiting.
Patients with a diagnosed pituitary tumor should have a heightened level of suspicion if these symptoms arise.
Update Date: 8/6/2004 Updated by: Aniket R. Sidhaye, M.D., Division of Endocrinology and Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network.
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Page last updated: 28 October 2004 |