Pituitary apoplexy outcome [Neurosurgery Wiki]

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====== Pituitary apoplexy outcome ======

[[Mass effect]] may occur suddenly as a result of tumor expansion with pituitary apoplexy


The [[visual acuity]] outcome after [[pituitary apoplexy]] appears to be better in early [[intervention]] as compared to late. Nevertheless, good visual recovery is also seen in late surgical intervention
((Abdulbaki A, Kanaan I. The impact of surgical timing on visual outcome in
pituitary apoplexy: Literature review and case illustration. Surg Neurol Int.
2017 Feb 6;8:16. doi: 10.4103/2152-7806.199557. eCollection 2017. Review. PubMed 
PMID: 28217395; PubMed Central PMCID: PMC5309450.
)).

The timing of surgical intervention relative to the onset of [[symptom]]s does not appear to significantly affect the resolution of neurological or endocrinological deficits
((Rutkowski MJ, Kunwar S, Blevins L, Aghi MK. Surgical intervention for
pituitary apoplexy: an analysis of functional outcomes. J Neurosurg. 2017 Sep
15:1-8. doi: 10.3171/2017.2.JNS1784. [Epub ahead of print] PubMed PMID: 28946177.
)).

The outcome of most patients with pituitary apoplexy is excellent. Selected patients can be managed conservatively, and patients with severe neuro-ophthalmological deficits treated with early surgery can achieve an excellent recovery
((Singh TD, Valizadeh N, Meyer FB, Atkinson JL, Erickson D, Rabinstein AA.
Management and outcomes of pituitary apoplexy. J Neurosurg. 2015
Jun;122(6):1450-7. doi: 10.3171/2014.10.JNS141204. Epub 2015 Apr 10. PubMed PMID:
25859804.
)). 

Normal and high preoperative [[PRL]] levels are associated with better endocrine outcome after surgery. The patients benefit from surgical intervention even after delayed diagnosis with the serum PRL levels is being a valid biomarker for clinical decision making
((Lammert A, Walter MS, Giordano FA, Al Zhgloul M, Krämer BK, Nittka S, Schulte 
DM, Ratliff M, Hänggi D, Seiz-Rosenhagen M. Neuro-Endocrine Recovery After
Pituitary Apoplexy: Prolactin as a Predictive Factor. Exp Clin Endocrinol
Diabetes. 2018 Jul 2. doi: 10.1055/a-0640-2915. [Epub ahead of print] PubMed
PMID: 29966153.
)).

===== References =====