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A Case-Based Guide to Clinical EndocrinologyPituitary Apoplexy

A Case-Based Guide to Clinical Endocrinology: Pituitary Apoplexy Chapter 1 Steven Jon Russell and Karen Klahr Miller Objectives To understand the clinical presentation, the evaluation, the acute medical and surgical management, the long-term management, and the complications of pituitary apoplexy. Case Presentation A 36-year-old woman presented to her primary care physician on an urgent basis with “the worst headache of my life.” The headache started suddenly. She took an over-the-counter analgesic but vomited soon after swallowing it. She also noticed blurry and double vision while searching for her doctor’s phone number. In the doctor’s office her heart rate was 115 beats per minute and blood pressure was 90/50 mm Hg. Left eye ptosis was noted as well as a dilated left pupil that did not react to light. The left eye was deviated downward and outward. The patient felt light-headed but had a normal gait, and strength and sensation were grossly intact for all extremities. She was transported promptly to the nearby hospital emergency room. In the emergency room she denied any significant medical history. Her only medication was oral contraceptive pills. A brain computed tomography (CT) scan without contrast was obtained emergently. There was no evidence of subarachnoid hemorrhage or hemorrhage into the brain parenchyma, but http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png

A Case-Based Guide to Clinical EndocrinologyPituitary Apoplexy

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Publisher
Humana Press
Copyright
© Humana Press,Totowa, NJ 2008
ISBN
978-1-58829-815-7
Pages
9 –17
DOI
10.1007/978-1-60327-103-5_1
Publisher site
See Chapter on Publisher Site

Abstract

Chapter 1 Steven Jon Russell and Karen Klahr Miller Objectives To understand the clinical presentation, the evaluation, the acute medical and surgical management, the long-term management, and the complications of pituitary apoplexy. Case Presentation A 36-year-old woman presented to her primary care physician on an urgent basis with “the worst headache of my life.” The headache started suddenly. She took an over-the-counter analgesic but vomited soon after swallowing it. She also noticed blurry and double vision while searching for her doctor’s phone number. In the doctor’s office her heart rate was 115 beats per minute and blood pressure was 90/50 mm Hg. Left eye ptosis was noted as well as a dilated left pupil that did not react to light. The left eye was deviated downward and outward. The patient felt light-headed but had a normal gait, and strength and sensation were grossly intact for all extremities. She was transported promptly to the nearby hospital emergency room. In the emergency room she denied any significant medical history. Her only medication was oral contraceptive pills. A brain computed tomography (CT) scan without contrast was obtained emergently. There was no evidence of subarachnoid hemorrhage or hemorrhage into the brain parenchyma, but

Published: Jan 1, 2008

Keywords: Growth Hormone; Luteinizing Hormone; Cavernous Sinus; Diabetes Insipidus; Optic Chiasm

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