{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T19:13:37Z","timestamp":1772478817377,"version":"3.50.1"},"reference-count":19,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2013,11,9]],"date-time":"2013-11-09T00:00:00Z","timestamp":1383955200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2014,5]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Advanced magnetic resonance imaging (<jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>) and optical instruments for surgery frequently demonstrate subclinical haemorrhage in pituitary adenomas; however, the effects of subclinical haemorrhage on pituitary glands remain unclear. We sought to clarify the pituitary function in patients with subclinical pituitary adenoma haemorrhage (<jats:styled-content style=\"fixed-case\">SPAH<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design\/Patients<\/jats:title><jats:p>Between January 2006 and December 2012, we retrospectively reviewed 328 consecutive patients who underwent surgery for pituitary adenoma. <jats:styled-content style=\"fixed-case\">SPAH<\/jats:styled-content> was defined as an intratumoral haemorrhage based on both 3\u00a0tesla <jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content> and operative findings, with no clinical symptoms of acute pituitary adenoma apoplexy. The pituitary dysfunction assessed using pre\u2010 and postoperative provocative tests was investigated in patients categorized into three groups: nonapoplectic adenoma, adenoma with <jats:styled-content style=\"fixed-case\">SPAH<\/jats:styled-content> and adenoma with clinical apoplexy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>The main outcome measure was the incidence of pituitary dysfunction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The overall incidence of nonapoplectic adenomas, adenomas with <jats:styled-content style=\"fixed-case\">SPAH<\/jats:styled-content> and adenomas with clinical apoplexy was 82\u00b73%, 14\u00b73% and 3\u00b74%, respectively. Clinical pituitary apoplexy frequently occurred in male patients with large nonfunctioning adenomas, causing pituitary dysfunction. Contrastingly, the incidence of <jats:styled-content style=\"fixed-case\">SPAH<\/jats:styled-content> was significantly higher in the patients with prolactinoma (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0\u00b70260), including those with relatively small adenomas (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0\u00b70007). No medications, such as dopamine agonists or somatostatin analogues, were observed to affect the occurrence of <jats:styled-content style=\"fixed-case\">SPAH<\/jats:styled-content>. No deterioration of the pituitary function was observed in the <jats:styled-content style=\"fixed-case\">SPAH<\/jats:styled-content> patients in comparison with the patients with nonapoplectic adenoma, and the size of the haematoma occupying the pituitary adenoma did not exhibit any relationships with the deterioration of the pituitary function. Furthermore, <jats:styled-content style=\"fixed-case\">SPAH<\/jats:styled-content> caused no deterioration of the pituitary function after a surgery based on the postoperative provocation tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Subclinical pituitary adenoma haemorrhage does not cause any added dysfunction in pituitary glands. Signs of haemorrhage in pituitary adenomas do not necessitate immediate tumour decompression surgery, if there are no symptoms of acute haemorrhage.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.12349","type":"journal-article","created":{"date-parts":[[2013,10,14]],"date-time":"2013-10-14T11:58:07Z","timestamp":1381751887000},"page":"720-725","source":"Crossref","is-referenced-by-count":29,"title":["Impact of subclinical haemorrhage on the pituitary gland in patients with pituitary adenomas"],"prefix":"10.1111","volume":"80","author":[{"given":"Yasuyuki","family":"Kinoshita","sequence":"first","affiliation":[{"name":"Department of Neurosurgery Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Tominaga","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Usui","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazunori","family":"Arita","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Graduate School of Medical and Dental Sciences Kagoshima University Kagoshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuhiko","family":"Sugiyama","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology and Neuro\u2010oncology Program Hiroshima University Hospital Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaoru","family":"Kurisu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,11,9]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2010.03913.x"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2009.01.003"},{"key":"e_1_2_8_4_1","article-title":"Pituitary adenomas in childhood and adolescence with a focus on intratumoral hemorrhage","author":"Kinoshita Y.","year":"2012","journal-title":"Pituitary"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2009.11.012"},{"key":"e_1_2_8_6_1","unstructured":"The Hypothalamic\u2010Pituitary Dysfunction Study Group of the Ministry of Health Labour and Welfare Japan(2010)The Guideline for the diagnosis and treatment of hyperprolactinemia. 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