Endocrine Abstracts

Pituitary apoplexy is an uncommon emergency. It presents often with sudden thunder clap headaches and requires multidisciplinary team involvement. This includes an experienced neurosurgeon, endocrinologist, radiologist – the pituitary multidisciplinary team.

Urgent treatment should be given often involving steroids (after a blood cortisol has been taken). Assessment includes neurological signs which if severe may merit urgent surgery.

Surgery in these circumstances is controversial but certainly if there is profound neurological sequela including third, fourth or sixth cranial nerve problems and optic nerve problems, early surgery should be recommended to decompress the neural pathways.

Ongoing studies looking to see whether urgent surgery improves neurological outcomes in borderline cases.

Patients who have had pituitary apoplexy require long-term follow-up because pituitary tumours which commonly cause this problem can recur.