Ischemic Infarction of Pituitary Apoplexy: A Retrospective Study of 46 Cases From a Single Tertiary Center Article Swipe
YOU?
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· 2022
· Open Access
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· DOI: https://doi.org/10.3389/fnins.2021.808111
Objective Ischemic infarction of pituitary apoplexy (PA) is a rare type of pituitary apoplexy. This study aims to characterize ischemic PA via clinical presentations, imaging data, histopathological manifestations, and focus on the management and prognosis of the disease. Methods This study retrospectively identified 46 patients with ischemic PA confirmed using histopathology at a single institution from January 2013 to December 2020. The clinical presentations, imaging data, laboratory examination, management, and outcomes were collected. We then summarized the clinical presentations, imaging features, intraoperative findings, and histopathological manifestations, and compared the outcomes based on the timing of surgical intervention. Results Headache was the most common initial symptom (95.65%, 44/46), followed by visual disturbance (89.13%, 41/46), and nausea and vomiting (58.70%, 27/46). 91.3% of the patients had at least one pituitary dysfunction, with hypogonadism being the most common endocrine dysfunction (84.78%, 39/46). Cortisol dysfunction occurred in 24 (52.17%) patients and thyroid dysfunction occurred in 17 (36.96%). Typical rim enhancement and thickening of the sphenoid sinus on MRI were seen in 35 (85.37%) and 26 (56.52%) patients, respectively. Except for one patient with asymptomatic apoplexy, the remaining patients underwent early (≤ 1 week, 12 patients) and delayed (> 1 week, 33 patients) transsphenoidal surgery. Total tumor resection was achieved in 27 patients and subtotal tumor resection in 19 patients. At surgery, cottage cheese–like necrosis was observed in 50% (23/46) of the patients. At the last follow-up of 5.5 ± 2.7 years, 92.68% (38/41) of the patients had gained a significant improvement in visual disturbance regardless of surgical timing, and 65% of the patients were still receiving long-term hormone replacement therapy. Conclusion Patients with ischemic PA can be accurately diagnosed by typical imaging characteristics preoperatively. The timing of surgical intervention does not significantly affect the resolution of neurological and endocrinological dysfunctions. Preoperative endocrine dysfunctions are common and usually appear to be poor after surgical intervention.
Related Topics
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.3389/fnins.2021.808111
- https://www.frontiersin.org/articles/10.3389/fnins.2021.808111/pdf
- OA Status
- gold
- Cited By
- 15
- References
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- Related Works
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- OpenAlex ID
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Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4207008730Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.3389/fnins.2021.808111Digital Object Identifier
- Title
-
Ischemic Infarction of Pituitary Apoplexy: A Retrospective Study of 46 Cases From a Single Tertiary CenterWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2022Year of publication
- Publication date
-
2022-01-24Full publication date if available
- Authors
-
Qiang Zhu, Yuchao Liang, Ziwen Fan, Yukun Liu, Chunyao Zhou, Hong Zhang, Tianshi Li, Yanpeng Zhou, Jianing Yang, Yinyan Wang, Lei WangList of authors in order
- Landing page
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https://doi.org/10.3389/fnins.2021.808111Publisher landing page
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https://www.frontiersin.org/articles/10.3389/fnins.2021.808111/pdfDirect link to full text PDF
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YesWhether a free full text is available
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goldOpen access status per OpenAlex
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https://www.frontiersin.org/articles/10.3389/fnins.2021.808111/pdfDirect OA link when available
- Concepts
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Medicine, Pituitary apoplexy, Histopathology, Transsphenoidal surgery, Asymptomatic, Surgery, Single Center, Infarction, Retrospective cohort study, Nausea, Vomiting, Pituitary adenoma, Internal medicine, Myocardial infarction, Adenoma, PathologyTop concepts (fields/topics) attached by OpenAlex
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15Total citation count in OpenAlex
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2025: 2, 2024: 4, 2023: 6, 2022: 3Per-year citation counts (last 5 years)
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60Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.(58.70%, | 117 |
| abstract_inverted_index.(84.78%, | 137 |
| abstract_inverted_index.(85.37%) | 168 |
| abstract_inverted_index.(89.13%, | 111 |
| abstract_inverted_index.(95.65%, | 105 |
| abstract_inverted_index.Cortisol | 139 |
| abstract_inverted_index.December | 59 |
| abstract_inverted_index.Headache | 98 |
| abstract_inverted_index.Ischemic | 1 |
| abstract_inverted_index.Patients | 267 |
| abstract_inverted_index.achieved | 204 |
| abstract_inverted_index.apoplexy | 5 |
| abstract_inverted_index.clinical | 22, 62, 77 |
| abstract_inverted_index.compared | 87 |
| abstract_inverted_index.disease. | 37 |
| abstract_inverted_index.followed | 107 |
| abstract_inverted_index.ischemic | 19, 46, 269 |
| abstract_inverted_index.necrosis | 219 |
| abstract_inverted_index.observed | 221 |
| abstract_inverted_index.occurred | 141, 149 |
| abstract_inverted_index.outcomes | 70, 89 |
| abstract_inverted_index.patients | 44, 122, 145, 183, 207, 241, 258 |
| abstract_inverted_index.sphenoid | 160 |
| abstract_inverted_index.subtotal | 209 |
| abstract_inverted_index.surgery, | 216 |
| abstract_inverted_index.surgery. | 199 |
| abstract_inverted_index.surgical | 95, 252, 283, 308 |
| abstract_inverted_index.therapy. | 265 |
| abstract_inverted_index.vomiting | 116 |
| abstract_inverted_index.(> | 193 |
| abstract_inverted_index.(36.96%). | 152 |
| abstract_inverted_index.Objective | 0 |
| abstract_inverted_index.apoplexy, | 180 |
| abstract_inverted_index.apoplexy. | 13 |
| abstract_inverted_index.confirmed | 48 |
| abstract_inverted_index.diagnosed | 274 |
| abstract_inverted_index.endocrine | 135, 297 |
| abstract_inverted_index.features, | 80 |
| abstract_inverted_index.findings, | 82 |
| abstract_inverted_index.follow-up | 231 |
| abstract_inverted_index.long-term | 262 |
| abstract_inverted_index.patients) | 190, 197 |
| abstract_inverted_index.patients, | 172 |
| abstract_inverted_index.patients. | 214, 227 |
| abstract_inverted_index.pituitary | 4, 12, 127 |
| abstract_inverted_index.prognosis | 34 |
| abstract_inverted_index.receiving | 261 |
| abstract_inverted_index.remaining | 182 |
| abstract_inverted_index.resection | 202, 211 |
| abstract_inverted_index.underwent | 184 |
| abstract_inverted_index.Conclusion | 266 |
| abstract_inverted_index.accurately | 273 |
| abstract_inverted_index.collected. | 72 |
| abstract_inverted_index.identified | 42 |
| abstract_inverted_index.infarction | 2 |
| abstract_inverted_index.laboratory | 66 |
| abstract_inverted_index.management | 32 |
| abstract_inverted_index.regardless | 250 |
| abstract_inverted_index.resolution | 290 |
| abstract_inverted_index.summarized | 75 |
| abstract_inverted_index.thickening | 157 |
| abstract_inverted_index.disturbance | 110, 249 |
| abstract_inverted_index.dysfunction | 136, 140, 148 |
| abstract_inverted_index.enhancement | 155 |
| abstract_inverted_index.improvement | 246 |
| abstract_inverted_index.institution | 54 |
| abstract_inverted_index.management, | 68 |
| abstract_inverted_index.replacement | 264 |
| abstract_inverted_index.significant | 245 |
| abstract_inverted_index.Preoperative | 296 |
| abstract_inverted_index.asymptomatic | 179 |
| abstract_inverted_index.characterize | 18 |
| abstract_inverted_index.dysfunction, | 128 |
| abstract_inverted_index.dysfunctions | 298 |
| abstract_inverted_index.examination, | 67 |
| abstract_inverted_index.hypogonadism | 130 |
| abstract_inverted_index.intervention | 284 |
| abstract_inverted_index.neurological | 292 |
| abstract_inverted_index.cheese–like | 218 |
| abstract_inverted_index.dysfunctions. | 295 |
| abstract_inverted_index.intervention. | 96, 309 |
| abstract_inverted_index.respectively. | 173 |
| abstract_inverted_index.significantly | 287 |
| abstract_inverted_index.histopathology | 50 |
| abstract_inverted_index.intraoperative | 81 |
| abstract_inverted_index.presentations, | 23, 63, 78 |
| abstract_inverted_index.characteristics | 278 |
| abstract_inverted_index.manifestations, | 27, 85 |
| abstract_inverted_index.preoperatively. | 279 |
| abstract_inverted_index.retrospectively | 41 |
| abstract_inverted_index.transsphenoidal | 198 |
| abstract_inverted_index.endocrinological | 294 |
| abstract_inverted_index.histopathological | 26, 84 |
| cited_by_percentile_year.max | 98 |
| cited_by_percentile_year.min | 95 |
| corresponding_author_ids | https://openalex.org/A5100435992 |
| countries_distinct_count | 1 |
| institutions_distinct_count | 11 |
| corresponding_institution_ids | https://openalex.org/I183519381, https://openalex.org/I4210087691 |
| sustainable_development_goals[0].id | https://metadata.un.org/sdg/3 |
| sustainable_development_goals[0].score | 0.7099999785423279 |
| sustainable_development_goals[0].display_name | Good health and well-being |
| citation_normalized_percentile.value | 0.88865326 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | True |