Transsphenoidal Surgical Decompression in Pituitary Apoplexy

Abstract

Background: Pituitary apoplexy (PA) is one of the most serious, life-threatening complications of pituitary adenoma. In recent years, more surgeons have adopted the endonasal transsphenoidal approach to treat patients with PA. We retrospectively analyzed the clinical presentation and the operation effect on patients with PA. Methods: We performed a retrospective analysis of microsurgical transsphenoidal approach for 72 patients with PA, including the clinical features, radiologic data, the results of follow-up, and the complications. Results: Among 979 patients with pituitary tumor, 72 patients presented with PA. All of them had multiple chronic syndrome. The visual impairment or visual field defect was present in 46 patients, 38 of them improved significantly after surgery (82.61%), whereas the remaining patients did not improve. The endocrine symptoms recovered in all (24) but 4 patients (83.33%). The tumor in 63 patients were completely resected, subtotal in 9 cases, total resection rate of the tumor was 87.50%. All but 6 patients had postoperative diabetes insipidus and 3 patients developed cerebrospinal fluid leakage. After treatment, all of them were cured. Conclusions: Transsphenoidal surgical decompression is a safe, well-tolerated, and effective treatment for patients with PA, and should be given preferentially.