Is it Necessary to Operate on Patients with Pituitary Hemorrhage?

Kutin MA1, Kalinin PL1,2, Kadashev BA1, Astafieva LI1, Shakrubo AN1, Fomichev DV1, Sharipov OI1, Sidoruk EV3, Urakov SV1, Voronina IA1, Serova NK1, Tropinskaya OF1, Sidneva YG1, Potin DL4, Shishkina LV1, Turkin AM1, Shultz YI1, Donskoy AD1, Klochkova IS1, Sinelnikov MY3 and Chernov IV1*

1N.N. Burdenko National Medical Research Center of Neurosurgery, Russia
2Peoples' Friendship University of Russia, Russia
3Sechenov University, Russia
4Loginov Moscow Clinical Centre, Russia

^*Correspondance to: Ilya V Chernov 

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Abstract:

Background: Pituitary tumors are a common pathology in neuro-oncology. It is not uncommon that pituitary apoplexy is the first manifestation of the disease, and the choice of optimal tactic is important. Considering the presence of observations of spontaneous resorption of tumors after pituitary apoplexy, the standard approaches to this pathology require revision. Objectives: We aim to identifying factors that contribute to tumor resorption and compare conservative and surgical treatment methods. Methods: We review the results of treatment of 82 patients with pituitary apoplexy. 45 patients were surgically managed and 37 patients were managed conservatively. Results: Tumor size has a direct link with the rate of spontaneous resorption rates, along with hemorrhage type and localization. Dexamethasone plays an important role in conservative therapy, significantly improving outcome. Conservative treatment methods, when applied with the described algorithm allow for highly efficient results, comparable to urgent surgical intervention. Conclusion: Based on our results, we propose an updated algorithm for the treatment of patients with pituitary apoplexy. The application of the proposed algorithm will allow in some cases to avoid emergency surgery and obtain a comparable clinical result with lower patient risk.

Keywords:

Pituitary apoplexy; Transnasal adenomectomy; Pituitary hemorrhage

Cite the Article:

Kutin MA, Kalinin PL, Kadashev BA, Astafieva LI, Shakrubo AN, Fomichev DV, et al. Is it Necessary to Operate on Patients with Pituitary Hemorrhage?. Ann Clin Case Rep. 2023; 8: 2429..