Pituitary apoplexy is a condition in which the pituitary tumor spontaneously hemorrhages (bleeds). The term "pituitary apoplexy" can also describe a less common condition when a pituitary tumor outgrows its blood supply (a stroke).
The UCLA Pituitary Tumor Program offers comprehensive management of pituitary apoplexy. Our physicians have years of experience in diagnosing, treating and managing pituitary conditions.
Use these links to explore more about pituitary apoplexy:
All types of pituitary adenomas can be associated with apoplexy, particularly larger tumors (macroadenomas).
The term apoplexy usually describes larger bleeds leading to the sudden onset of symptoms.
Doctors may suspect pituitary apoplexy because there is a sudden increase in the size of the tumor. This sudden increase may compress the:
Pituitary apoplexy is rarely life threatening, if you receive prompt and accurate diagnosis and treatment.
The compression may also lead to a loss of blood supply (pituitary infarct), which can cause tumor cell death, bleeding and sudden tumor swelling.
It is difficult to predict who will develop pituitary apoplexy, although it has been associated with a wide range of disorders and treatment side effects. In many cases, doctors see small hemorrhages into a pituitary tumor on magnetic resonance imaging (MRI) scan, which were not associated with an "apoplectic" event.
Symptoms of pituitary apoplexy vary, but may include:
Increased compression of the normal gland can cause hormone insufficiency, called hypopituitarism. The symptoms depend upon which hormone is involved.
More severe hypopituitarism can lead to hypothyroidism or abnormally low cortisol levels, which may be life threatening. Symptoms of severe hypopituitarism include:
Changes in hormonal function can cause electrolyte imbalance in the blood, typically low sodium levels (hyponatremia). Symptoms could include:
Your doctor will conduct a thorough physical exam and ask you about your symptoms and medical history. Other diagnostic procedures include:
One method doctors use to diagnose pituitary apoplexy is using MRI scans. At the UCLA Pituitary Tumor Program, we use a special MRI pituitary protocol in order to best visualize the tumor. Our specialists examine the scan together to determine the size of the bleed.
You may also undergo a computerized tomography (CT) scan of the pituitary gland, which will also show if there is an abnormality.
If your symptoms suggest pituitary failure (hypopituitarism), you need a complete evaluation of the endocrine system.
Based on results of these blood tests, your doctor may order additional hormonal studies.
Learn more about hormone testing at the UCLA Pituitary Tumor Program.
If you suffer from visual symptoms, then an experienced ophthalmologist should evaluate you. This evaluation should include:
After diagnosis, you will begin your course of treatment. Treatment options for pituitary apoplexy include:
If the pituitary adenomas require surgery, typically the best procedure is through a nasal approach. Our neurosurgeons who specialize in pituitary tumor surgery are experts in the minimally invasive endoscopic endonasal technique. This procedure removes the tumor while minimizing complications, hospital time and discomfort. This advanced technique requires specialized training and equipment.
No matter what course of treatment you undergo, one of our experienced endocrinologists will monitor you carefully during treatment and recovery.
Most patients have significant visual improvement after surgery; however, a majority will have permanent hormone deficiencies due to pituitary injury. You may require hormone replacement therapy for life.
To schedule an appointment with one of our physicians at the Pituitary Tumor Program, please call (310) 825 5111.
