Abstract SINCE Brougham et al6 in 1950 reviewed the literature and reported five new cases of pituitary apoplexy, there has been an increasing interest in the subject. Subsequent physicians22,26,45 reporting their clinical experiences have cited other recorded cases so that the total number now stands at or near 85.2-11,13-15,17-26, 30-33,35-49 We have recently treated two additional patients with spontaneous hemorrhage into pituitary adenomata. The details of these are reported here. Clinical Summaries Case 1.—A 63-year-old bricklayer was transferred from another hospital on April 29, 1960, for evaluation of headache, diplopia, drowsiness, nausea, and vomiting of five days duration. In 1954 a routine chest x-ray had shown multiple pulmonary densities which were thought to represent silicosis. However, metastatic tumor was considered, and a lateral skull film taken as part of a routine metastatic bone series showed an enlarged sella turcica. Endocrine studies showed normal 17-ketosteroid and 17-hydroxysteroid excretion values References 1. Altshuler, S. S., and Gould, S. E.: Diabetes Refractory to Insulin, With Report of Case , Ann Intern Med 9:1595-1603, 1936.Crossref 2. Bastenie, P. A.: Guérison d'un diabéte acromégalique par accident vasculaire dans l'adenome hypophysaire , Acta Clin Belg 1:63-71, 1946. 3. Benjamin, J. E.: Pituitary Tumor With Fulminating Symptoms , JAMA 92:1755-1759, 1929.Crossref 4. Bergonzi, M., and Pelagatti, V.: Contributo allo studia dei tumori della ipofisi cerebrale: Nota anatomo-clinica e statistica , Pathologica 23:734-743, 1931. 5. Bleibtreau, L.: Ein Fall von Akromegalie (Zerstörung der Hypophysis durch Blutung) , Munchen Med Wschr 52:2079-2080, 1905. 6. Brougham, M.; Heusner, A. P.; and Adams, R. D.: Acute Degenerative Changes in Adenomas of Pituitary Body—With Special Reference to Pituitary Apoplexy , J Neurosurg 7:421-439, 1950.Crossref 7. Cairns, H.: Peripheral Ocular Palsies From Neuro-Surgical Point of View , Trans Ophthal Soc UK ( (pt 2) ) 58:464-482, 1938. 8. Coxon, R. V.: Case of Hemorrhage Into Pituitary Tumor Simulating Rupture of Intracranial Aneurysm , Guy Hosp Rep 92:89-93, 1943. 9. Davidoff, L. M., and Feiring, E. H.: Surgical Treatment of Tumors of Pituitary Body , Amer J Surg 75:99-136, 1948.Crossref 10. Deak, E.: Über vier Fälle von extrasellaren Hypophysengeschwülsten , Zbl Allg Path 51:1-6, 1931. 11. Dingley, L. A.: Sudden Death Due to Tumour of Pituitary Gland , Lancet 2:183-184, 1932.Crossref 12. Dott, N. M.; Bailey, P.; and Cushing, H.: Consideration of Hypophyseal Adenomata , Brit J Surg 13:314-366, 1925.Crossref 13. Fager, C. A.: " Intrasellar Surgical Lesions: Cystic and Hemorrhagic Adenomas Requiring Surgery After X-Ray Therapy ," in Surgical Practice of Lahey Clinic , Philadelphia: W. B. Saunders Co., 1962, pp 26-35. 14. Fountain, E. M.; Baird, W. C.; and Poppen, J. L.: Pituitary Apoplexy: Report of Three Cases With Recovery , Lahey Clin Bull 7:117-122, 1951. 15. Glass, B., and Abbott, K. H.: Subarachnoid Hemorrhage Consequent to Intracranial Tumors , AMA Arch Neurol Psychiat 73:369-379, 1955.Crossref 16. Gurling, K. J.: Diabetic Coma and Pituitary Necrosis in Acromegalic Patient , Diabetes 4:138-140, 1955. 17. Irsigler, F. J.: Surgical Emergencies Related to Pituitary and Neighbouring Areas , S Afr Med J 34:10-14, 1960. 18. Jefferson, G.: Extrasellar Extensions of Pituitary Adenomas , Proc Roy Soc Med 33:433-445, 1940. 19. Jefferson, M., and Rosenthal, F. D.: Spontaneous Necrosis in Pituitary Tumors (Pituitary Apoplexy) , Lancet 1:342-344, 1959.Crossref 20. Jolley, F. L., and Mabon, R. I.: Pituitary Apoplexy , J Med Ass Georgia 47:75-78, 1958. 21. Kirshbaum, J. D., and Chapman, B. M.: Subarachnoid Hemorrhage Secondary to Tumor of Hypophysis With Acromegaly , Ann Intern Med 29:536-540, 1948.Crossref 22. Krueger, E. G.; Unger, S. M.; and Roswit, B.: Hemorrhage Into Pituitary Adenoma With Spontaneous Recovery and Reossification of Sella Turcica , Neurology 10:691-696, 1960.Crossref 23. Kux, E.: Über ein bösartiges Pinealom und ein bösartiges fötales Adenom der Hypophyse , Beitr Path Anat 87:59-70, 1931. 24. Lenshoek, C. H.: Chromophoob hypophyseadenoom met beiderzijdsche complete ophthalmoplegie , Nederl T Geneesk 90:1596-1597, 1946. 25. List, C. F.; Williams, J. R.; and Balyeat, G. W.: Vascular Lesions in Pituitary Adenomas , J Neurosurg 9:177-187, 1952.Crossref 26. Locke, S., and Tyler, H. R.: Pituitary Apoplexy , Amer J Med 30:643-648, 1961.Crossref 27. Long, E. R.: Adenoma of Hypophysis Without Acromegaly, Hypopituitarism or Visual Disturbances, Terminating in Sudden Death , Arch Neurol Psychiat 18:576-584, 1927.Crossref 28. Mahmoud, M. E. S.: Sella in Health and Disease , Brit J Radiol , (suppl 8) , p 37, 1958. 29. Monro, J. D. R.: Case of Sudden Death; Tumour of Pituitary Body , Lancet 2:1539, 1913.Crossref 30. Muller, W., and Pia, H. W.: Zur Klinik und Atiologie der Massenblutungen in Hypophysenadenome , Deutsch Z Nervenheilk 170:326-336, 1953. 31. Oberdisse, K., and Tönnis, W.: Pathophysiologie, Klinik und Behandlung der Hypophysenadenome , Ergebn Inn Med Kinderheilk 1953 , 4:975-1057, 1953. 32. Obrador Alcade, S., and Urquiza Villanueva, P.: Compresion quiasmatica aguda por hematoma intratumoral en adenoma de la hipofisis , Rev Esp Otoneurooftal 9:333-337, 1950. 33. Paleari, S., and Morello, G.: Un caso di emorragia subaracnoidea recidicante con oftalmopegia e cefalea da adenoma ipofisario , Chirurgia 1:257-262, 1946. 34. Philippidés, D., et al: Necrose d'un adenome de l'hypophyse: Signes oculaires , Rev Otoneuroophthal 28:101-103, 1956. 35. Pouyanne, L., et al: " La forme hémorragique dea adénomes chromophobes hypophysaires (á propos des trois observations) ," in Hommage á Clovis Vincent , Paris: Maloine, 1949, pp 81-84. 36. Puccini, C.: Adenoma ipofisario a cellule miste concomitante a carcinoma della tiroide e sede di apoplessia , Arch Anat Path 13:557-584, 1949. 37. Reverchon, L., et al: Contribution á l'étude des lésions traumatiques de l'hypophyse, volumineux kyste hemorragique de cette glande, consécutif á une contusion du crane , Rev Neurol 39:217-225, 1923. 38. Roberts, L. N., et al: Panhypopituitarism in Male Following Pituitary Apoplexy , Canad Med Ass J 66:458-461, 1952. 39. Röttgen, P., and Peters, G.: Über Massen blutungen in Hypophysenadenome , Zbl Neurochir 12:65-73, 1952. 40. Schloffer, H.: Weiterer Bericht Über den Fall von operiertem Hypophysentumor , Wien Klin Wschr 20:1075-1078, 1952. 41. Schnitker, M. T., and Lehnert, H. B.: Apoplexy in Pituitary Chromophobe Adenoma , J Neurosurg 1952 , 9:210-213, 1952. 42. Semerak, C. B.: Tumors of Hypophysis: Epithelial Infundibular Tumor; Adenomatous Hypertrophy of Hypophysis With Hemorrhage and Rupture Through Nasopharynx; Hypophyseal Cyst , Trans Chicago Path Soc 11:87-98, 1920. 43. Shenkin, H. A.: Relief of Amblyopia in Pituitary Apoplexy by Prompt Surgical Intervention , JAMA 159:1622-1624, 1955.Crossref 44. Sosman, M. C.: Roentgen Therapy of Pituitary Adenomas , JAMA 113:1282-1285, 1939.Crossref 45. Uihlein, A., et al: Acute Hemorrhage Into Pituitary Adenomas , J Neurosurg 14:140-151, 1957.Crossref 46. Van Wagenen, W. P.: Hemorrhage Into Pituitary Tumor Following Trauma , Ann Surg 95:625-628, 1932. 47. Voss, O.: Beitrag zur Hirnblutung an der Schädelbasis: Intrakranielle basale Blutungen , Deutsch Z Chir 250:727-735, 1938.Crossref 48. Walton, J. N.: Subarachnoid Hemorrhage of Unusual Etiology , Neurology 3:517-543, 1953.Crossref 49. Zajewloschin, M. N.: Ein Bluterguss in die Hypophysis cerebri , Frankfurt Z Path 37:328-330, 1929.
Archives of Neurology – American Medical Association
Published: Mar 1, 1965
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