Pituitary apoplexy Treatment
Treatment for Pituitary apoplexy should be given hormone replacement therapy to maintain water and electrolyte balance, in order to enhance stress capability and reduce acute edema under the optic nerve, hypothalamus, and let clinical symptoms tended to stabilize and reduce mortality. Type Ⅰ Pituitary apoplexy patients after confirmed diagnosis should be given immediate dehydration drug and hormone therapy and as soon as possible surgery to minimize the hypothalamus and the optic nerve, optic chiasm oppression; Type Ⅱ Pituitary apoplexy patients who may be first of all conservative treatment measures, when the general condition of patients improved, should be early surgical treatment; Type Ⅲ, Ⅳ-type Pituitary apoplexy patients, should promptly surgical treatment. The surgical methods used stereotactic treatment to rapid restoration of vision, nerve dysfunction, ease, and then radiotherapy to prevent recurrence.
1. the general first 50% of intravenous glucose 40-60ml, followed by 10% glucose 500-1000ml, with 100-300mg of hydrocortisone infusion, but a patient with low-temperature coma should not be given too large dosage of hydrocortisone.
2. patient with low temperaturee: the treatment is similar with myxedema coma, but should plus appropriate hydrocortisone before use of thyroid hormone (at least at the same time). In addition, prohibited the use of chlorpromazine, barbiturates and other central inhibitors.
3. coma with loss of sodium: liquid sodium to be added, the specific methods is same with adrenal crisis.
4. water intoxication coma: immediately give small or medium amount of glucocorticoid, and limited water.
5. pituitary apoplexy: should be a large number of hormone replacement therapy and hemostatic. Patient who have diabetes insipidus or syndrome of inappropriate antidiuretic hormone secretion should be tested metabolism of water and salt; patient who have severe increase in intracranial pressure, vision loss, coma or condition deteriorated should be surgical decompression.