Microsurgical treatment for typical pituitary apoplexy with 44 patients, according to two pathological stages.

ABSTRACT

OBJECTS The aim of this study was to explore the pathogenesis of typical pituitary apoplexy in different periods, to help to formulate a reasonable treatment program and to select the correct operation time. METHODS: Forty-four cases with pituitary apoplexy were diagnosed by the clinical presentation, pathological examination and surgical findings. Clinical manifestation, imaging features, surgical and pathological findings, as well as their relationships with the courses of this disease were analyzed retrospectively. RESULTS: The course of typical pituitary apoplexy was divided into two stages (the early hemorrhagic infarct stage and the late necrosis stage). The total removal rates in the early and late stage were 87.5% (14/16) and 100% (28/28), respectively. CONCLUSIONS: Typical pituitary apoplexy is mainly caused by hemorrhage secondary to necrosis after infarction. The staging of this disease provides an important guidance value to diagnosis and treatment. The surgical outcomes in the late stage were significantly better than those in the early stage. The patients without significant symptoms can be conservatively treated by hormone substitution therapy.