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- Title
Subarachnoid hemorrhage due to pituitary adenoma apoplexy—case report and review of the literature.
- Authors
Yildiz, Yesim; Lauber, Arno; Char, Natalia Velez; Bozinov, Oliver; Neidert, Marian Christoph; Hostettler, Isabel Charlotte
- Abstract
Pituitary apoplexy (PA) may be complicated by development of subarachnoid hemorrhage (SAH). We conducted a literature review to evaluate the rate of PA-associated tumor rupture and SAH. We conducted a systematic literature search (PubMed, Web of Science, Medline) for patients with PA-associated SAH and report a case SAH following PA. Suitable articles, case series, and case reports were selected based on predefined criteria following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). We reviewed included publications for clinical, radiological, surgical, and histopathological parameters.We present the case of a patient with PA developing extensive SAH whilst on the MRI who underwent delayed transsphenoidal resection. According to our literature review, we found 55 patients with a median age of 46 years; 18 (32.7%) were female. Factors associated with PA-related SAH were hypertension, diabetes mellitus, prior trauma, anticoagulant, and/or antiplatelet therapy. The most common presenting symptoms included severe headache, nausea and/or vomiting, impaired consciousness, and meningeal irritation. Acute onset was described in almost all patients. Twenty-two of the included patients underwent resection. In patients with available outcome, 45.1% had a favorable outcome, 10 (19.6%) had persisting focal neurological deficits, 7 developed cerebral vasospasms (12.7%), and 18 (35.3%) died. Mortality greatly differed between surgically (9.1%) and non-surgically (44.8%) treated patients. PA-associated SAH is a rare condition developing predominantly in males with previously unknown macroadenomas. Timely surgery often prevents aggravation or development of severe neuro-ophthalmological defects and improves clinical outcome.
- Subjects
SUBARACHNOID hemorrhage; LITERATURE reviews; PITUITARY tumors; CEREBROVASCULAR disease; CEREBRAL vasospasm; DIABETES
- Publication
Neurological Sciences, 2024, Vol 45, Issue 3, p997
- ISSN
1590-1874
- Publication type
Article
- DOI
10.1007/s10072-023-07130-y