Background: Background: Pituitary tumor apoplexy is a rare clinical syndrome resulting from the rapid and often life threatening expansion in the majority of cases of a pituitary tumor within the sella turcica, due to either hemorrhage or infarction. Objectives: This work aims at evaluating the role of the transsphenoidal endoscopic approach, adopting the endonasal route in the management of pituitary adenomas with apoplexy in thirty cases based on radiological, hormonal and visual parameters. Materials and methods: The study was conducted on thirty patients with pituitary tumor apoplexy in the Department of Neurosurgery at Banha University Hospitals and Cairo University Hospitals. Pituitary apoplexy was diagnosed based on the clinical characteristics, confirmation of pituitary hemorrhage/infarction on CT and/or MRI. Endoscopic endonasal transsphenoidal surgery was performed in all patients, followed by a tissue study. Five patients had stereotactic radiation therapy to control residual tumor. The patients were evaluated according to improvement in clinical and radiological basis, with follow-up on regular basis. Results: Between October 2012 and July 2015, thirty patients with pituitary adenomas with apoplexy were operated upon. The patients were fourteen females and sixteen males. In twenty four cases gross total resection was achieved, subtotal resection in five and one case of partial resection cases. In this study mortality was not recorded. Conclusion: absence of consensus in the management of pituitary apoplexy has been repeatedly recognized and still a matter of debate. However, transsphenoidal endoscopic excision for pituitary adenomas with apoplexy proves to be an efficient and safe method for management, yet high learning curve to master the technique is a must.
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