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Surgery Research and Practice
Volume 2014 (2014), Article ID 397131, 4 pages
http://dx.doi.org/10.1155/2014/397131
Case Report

Endoscopic Endonasal Transsphenoidal Resection for Pituitary Apoplexy during the Third Trimester of Pregnancy

1Department of Neurosurgery, Montefiore Medical Center, 3316 Rochambeau Avenue, Bronx, NY 10467, USA
2American Center for Spine and Neurosurgery, Libertyville, IL, USA
3Department of Otorhinolaryngology, Montefiore Medical Center, Bronx, NY, USA

Received 2 August 2013; Accepted 7 October 2013; Published 2 January 2014

Academic Editor: Tadanori Tomita

Copyright © 2014 Adesh Tandon et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Pituitary apoplexy is an uncommon phenomenon typically characterized by vascular insufficiency or acute hemorrhage into a pituitary adenoma. The overall incidence of pituitary apoplexy ranges between 1 and 25% of all pituitary adenomas. With the widespread use of MRI technology, the diagnosis of asymptomatic intratumoral hemorrhage is closer to 10%. The authors report a case of a 27-year-old female in her 36th week of pregnancy who presented with severe onset headache and acute left-sided vision loss. MRI of the brain revealed a large hemorrhagic mass occupying the sella turcica. The patient underwent an emergent endoscopic endonasal transsphenoidal resection for pituitary apoplexy. Postoperatively, the patient’s neurologic deficit resolved. Minimally invasive endoscopic endonasal transsphenoidal resection of pituitary apoplexy can be safely utilized in third trimester pregnant women presenting with acute severe neurologic deficits.