What causes pituitary apoplexy in pituitary adenomas?

Updated: Apr 20, 2020
  • Author: James R Mulinda, MD, FACP; Chief Editor: George T Griffing, MD  more...
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Pituitary apoplexy results from infarction of a pituitary tumor or sudden hemorrhage within. This presents as a medical emergency with a headache, sudden collapse, shock, and death if not treated emergently. This tends to occur in macroadenomas. Administration of stimulatory agents, such as thyroid-stimulating hormone TSH, gonadotropin-releasing hormone (GnRH), and insulin-hypoglycemia, have been postulated to lead to increased metabolic needs by the macroadenoma (which has deficient blood supply), leading to necrosis. In this context, apoplexy may be the presenting symptom of a gonadotropinoma in an elderly men receiving GnRH agonist therapy for prostate cancer.

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