ʻO ka pituitary a i ʻole pituitary apoplexy he maʻi kakaʻikahi akā koʻikoʻi. He pilikia olakino e pono ai ka hoʻokele kūpono.

Definition

ʻO ka apoplexy pituitary he puʻuwai puʻuwai a hemorrhage paha i loaʻa i loko o kahi pituitary adenoma (he maʻi endocrine maikaʻi, ʻaʻole-cancerous e ulu ana mai ka pituitary gland i loko o ka lolo). Ma mua o ka hapalua o nā hihia, hōʻike ka apoplexy i ka adenoma i hāʻawi ʻole i nā hōʻailona.

Nā kumu 

ʻAʻole maopopo i nā kumu o ka apoplexy pituitary. ʻO ka pituitary adenomas he mau maʻi koko e kahe a make maʻalahi paha. Hiki ke necrosis ma muli o ka hemahema o ka vascularization. 

PalekanaEND_LINK

ʻO ke kiʻi kiʻi pilikia (CT a i ʻole MRI) hiki ke hana i ka ʻike ma ka hōʻike ʻana i kahi adenoma i ke kaʻina o ka necrosis a i ʻole ka hemorrhage. Lawe pū ʻia nā laʻana koko wikiwiki. 

Pili ka poʻe 

Hiki ke loaʻa i ka pituitary apoplexy i kēlā me kēia makahiki akā maʻamau i kāu mau makahiki 3. Hoʻopilikia iki nā kāne ma mua o nā wahine. Hoʻopilikia ka pituitary apoplexy i ka 2% o nā kānaka me ka adenoma pituitary. Ma mua o 3 / XNUMX o nā hihia, ʻaʻole ʻike nā maʻi i ke ola o kā lākou adenoma ma mua o ka hoʻopiʻi nui. 

Nā mea pilikino 

Loaʻa i ka poʻe me ka pituitary adenoma nā kumu predisposing a precipitating: lawe i kekahi mau lāʻau lapaʻau, invasive examinations, high-risk pathologies (diabetes mellitus, angiographic examinations, coagulation disorders, anti-coagulation, pituitary stimulation test, radiotherapy, hapai, mālama me ka bromocriptine, isorbide. , chlorpromazine…)

Eia nō naʻe, ʻo ka hapa nui o nā hahau ʻana me ka ʻole o ke kumu precipitating.

ʻO ka pituitary a i ʻole pituitary apoplexy kahi hui o nā hōʻailona he nui, hiki ke ʻike ʻia i nā hola a i ʻole nā ​​​​lā. 

Headaches 

ʻO ke poʻo nui ka hōʻailona mua. Aia nā poʻo poni poni ma mua o ʻekolu hapaha o nā hihia. Hiki iā lākou ke hui pū me ka nausea, ka luaʻi, ke kuni, ka haunaele o ka ʻike, no laila e loaʻa ai ka maʻi meningeal. 

Nā haunaele ʻike 

ʻOi aku ma mua o ka hapalua o nā hihia o ka pituitary apoplexy, pili nā pilikia ʻike me ke poʻo. ʻO kēia nā hoʻololi a i ʻole ka nalowale o ka ʻike maka. ʻO ka mea maʻamau ka bitemporal hemianopia. He mea maʻamau nō hoʻi ka lolo oculomotor. 

Nā hōʻailona endocrine 

Hoʻopili pinepine ʻia ka apoplexy pituitary me ka lawa ʻole o ka pituitary (hypopituitarism) ʻaʻole paʻa mau.

ʻO ka hoʻokele o ka pituitary apoplexy he multidisciplinary: ophthalmologists, neuroradiologists, neurosurgeons a me endocrinologists. 

ʻO ka mālama ʻana i ka apoplexy he lāʻau lapaʻau pinepine. Hoʻohana ʻia ka hoʻololi ʻana i ka hormonal e hoʻoponopono i ka hemahema endocrinological: corticosteroid therapy, thyroid hormone therapy. ʻO kahi hoʻōla wai-electrolytic. 

Hiki i ka apoplexy ke kumuhana o kahi lapaʻau neurosurgical. ʻO kēia ka manaʻo e hoʻohaʻahaʻa i nā hale kūloko a me nā ala optical. 

ʻO ka corticosteroid therapy he systematic, inā paha e mālama ʻia ka aoplexy me ka neurosurgically a nānā ʻia me ka ʻole o ka ʻoki ʻana (ʻoi loa i nā poʻe me ka ʻike ʻole a i ʻole nā ​​​​maʻi ʻike ʻike a ʻaʻohe hemahema o ka ʻike). 

Ke wikiwiki ka hana, hiki ke ho'ōla hou ʻia, akā i ka wā o ka hoʻopaneʻe therapeutic hiki ke loaʻa ka makapō mau a i ʻole hemianopia. 

I nā mahina ma hope o ka apoplexy e hana ʻia kahi loiloi hou o ka hana pituitary, i mea e ʻike ai inā loaʻa nā hemahema pituitary mau.

ʻAʻole hiki ke pale i nā apoplexies pituitary. Eia nō naʻe, ʻaʻole pono ʻoe e haʻalele i nā hōʻailona o ka pituitary adenoma, ʻo ia hoʻi nā haʻalulu ʻike (hiki i nā adenomas ke hoʻopaʻa i nā aʻalolo o nā maka). 

ʻO ka ʻoki ʻana o ka adenoma e pale i kahi hanana hou o ka apoplexy pituitary. (1)

(1) Arafah BM, Taylor HC, Salazar R., Saadi H., Selman WR Apoplexy o kahi adenoma pituitary ma hope o ka ho'āʻo ikaika me ka hormone hoʻokuʻu gonadotropin. Am J Med 1989; 87: 103-105