{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T01:07:07Z","timestamp":1791594427110,"version":"4.3.4"},"reference-count":83,"publisher":"The Endocrine Society","issue":"9","license":[{"start":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T00:00:00Z","timestamp":1658966400000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Pituitary apoplexy (PA) is a rare clinical syndrome due to pituitary hemorrhage or infarction. It is characterized by the sudden onset of one or more of the following: severe headache, visual disturbance, nausea\/vomiting, and or altered mental status. Most commonly, PA occurs in an underlying pituitary adenoma. The pathophysiology is not fully understood, but it is thought to involve elements of increased metabolic demand and\/or compromise to the vasculature of the pituitary or pituitary tumor. Several risk factors have been described. Stabilization of the patient on presentation, replacement of hormonal deficiencies, and reversal of electrolyte abnormalities are the recommended initial steps in the management of patients with PA. Surgical decompression of the mass effect had been the recommended treatment for patients with PA; however, retrospective studies of patients with PA have demonstrated similar outcomes when a conservative approach is applied. This suggests that in highly selected clinical scenarios (mild visual deficit and improving symptoms), conservative management is possible. Further studies, however, are necessary to better stratify patients but are limited by the rarity of the condition and the acuity.<\/jats:p>","DOI":"10.1210\/jendso\/bvac113","type":"journal-article","created":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T01:19:29Z","timestamp":1658971169000},"source":"Crossref","is-referenced-by-count":45,"title":["Revisiting Pituitary Apoplexy"],"prefix":"10.1210","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5091-9582","authenticated-orcid":false,"given":"Diane","family":"Donegan","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism, Indiana University , Indianapolis, Indiana 46220 , USA"},{"name":"Division of Endocrinology, Diabetes and Metabolism, Mayo Clinic Minnesota , Rochester, Minnesota 55905 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9889-461X","authenticated-orcid":false,"given":"Dana","family":"Erickson","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Metabolism, Mayo Clinic Minnesota , Rochester, Minnesota 55905 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2022,7,26]]},"reference":[{"issue":"1","key":"2022080117485456100_CIT0001","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1111\/j.1365-2265.2010.03913.x","article-title":"UK guidelines for the management of pituitary apoplexy","volume":"74","author":"Rajasekaran","year":"2011","journal-title":"Clin Endocrinol (Oxf)."},{"issue":"6","key":"2022080117485456100_CIT0002","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1210\/er.2015-1042","article-title":"Pituitary apoplexy","volume":"36","author":"Briet","year":"2015","journal-title":"Endocr Rev."},{"issue":"2","key":"2022080117485456100_CIT0003","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1177\/0885066607312992","article-title":"Pituitary tumor apoplexy: a review","volume":"23","author":"Nawar","year":"2008","journal-title":"J Intensive Care Med."},{"key":"2022080117485456100_CIT0004","first-page":"789","article-title":"Pathological report of a case of acromegaly, with special reference to the lesions in the hypophysis cerebri and in the thyroid gland; and a case of haemorrhage into the pituitary","volume":"1","author":"Bailey","year":"1898","journal-title":"Philadelphia Med J."},{"issue":"5","key":"2022080117485456100_CIT0005","doi-asserted-by":"crossref","first-page":"421","DOI":"10.3171\/jns.1950.7.5.0421","article-title":"Acute degenerative changes in adenomas of the pituitary body\u2014with special reference to pituitary apoplexy","volume":"7","author":"Brougham","year":"1950","journal-title":"J Neurosurg."},{"issue":"3","key":"2022080117485456100_CIT0006","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1111\/j.1365-2265.2009.03667.x","article-title":"Prevalence of pituitary adenomas: a community-based, cross-sectional study in Banbury (Oxfordshire, UK)","volume":"72","author":"Fernandez","year":"2010","journal-title":"Clin Endocrinol (Oxf)."},{"issue":"9","key":"2022080117485456100_CIT0007","doi-asserted-by":"crossref","first-page":"4268","DOI":"10.1210\/jc.2010-0537","article-title":"Incidence of pituitary adenomas in Northern Finland in 1992-2007","volume":"95","author":"Raappana","year":"2010","journal-title":"J Clin Endocrinol Metab."},{"issue":"4","key":"2022080117485456100_CIT0008","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1210\/jc.2010-1054","article-title":"Natural history of nonfunctioning pituitary adenomas and incidentalomas: a systematic review and metaanalysis","volume":"96","author":"Fern\u00e1ndez-Balsells","year":"2011","journal-title":"J Clin Endocrinol Metab."},{"issue":"6","key":"2022080117485456100_CIT0009","doi-asserted-by":"crossref","first-page":"E18","DOI":"10.3171\/2011.9.FOCUS11217","article-title":"Incidental pituitary adenomas","volume":"31","author":"Sivakumar","year":"2011","journal-title":"Neurosurg Focus."},{"issue":"2","key":"2022080117485456100_CIT0010","doi-asserted-by":"crossref","first-page":"187","DOI":"10.3171\/jns.1981.55.2.0187","article-title":"Pituitary apoplexy: its incidence and clinical significance","volume":"55","author":"Wakai","year":"1981","journal-title":"J Neurosurg."},{"issue":"4","key":"2022080117485456100_CIT0011","first-page":"602","article-title":"A retrospective analysis of pituitary apoplexy","volume":"33","author":"Bills","year":"1993","journal-title":"Neurosurgery."},{"issue":"3-4","key":"2022080117485456100_CIT0012","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1007\/BF02112028","article-title":"Pituitary apoplexy: endocrine, surgical and oncological emergency. 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