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CASE REPORT

The acute stage of pituitary apoplexy complicated with sinusitis


1 Department of Surgery, Division of Neurosurgery, Kaohsiung Armed Forces General Hospital, Kaohsiung; Department of Neurological Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
2 Department of Surgery, Division of Urology, Kaohsiung Armed Forces General Hospital, Kaohsiung; Department of Surgery, Division of Urology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
3 Department of Neurological Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

Correspondence Address:
Chi-Tun Tang,
Department of Neurological Surgery, Tri-Service General Hospital, National Defense Medical Center, No. 325, Secection 2, Chenggong Road, Neihu District, Taipei City 114
Taiwan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jmedsci.jmedsci_147_20

The timely diagnosis and optimal therapy of the pituitary apoplexy is challenging. We report a case about our treatment experience for the acute stage of pituitary apoplexy complicated with sinusitis. It is the strong predictor for the acute stage of pituitary apoplexy when magnetic resonance imaging(MRI) presented the both signs simultaneously, the pituitary ring sign and the sphnoid sinus mucosal thickening. Once the diagnosis of pituitary apoplexy is established, hypocortisolism and hyponatremia should be considered intensely. Surgical decompression via transsphnoid approach has favorable prognosis for the visual involvement of the pituitary apoplexy. Effective antibiotic for sphenoid sinusitis before surgery may could minimize the postoperative risk of intracranial infection. Otherwise, the sign of the sphenoid sinus mucosal thickening is not a contraindication for the transnasal transsphnoidal surgery.


 

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    -  Li CC
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