PITUITARY-APOPLEXY

SUMMARY

1. present(s) with sudden onset headache, meningismus, visual field defect, nausea/vomiting, fluctuating consciousness.

2. Beware: life-threatening hypotension from central or secondary adrenal insufficiency.

3. DDx: SAH, Sheehan's syndrome.

4. Risk factors: DM with microvascular changes, radiotherapy, anticoagulation.

5. Inx: low serum cortisol.

6. Imaging: plain CT brain.

7. Indication for emergent surgery: visual defect, mass effect causing decreased consciousness.

8. Medical managament for mild symptoms: corticosteroids.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].