Pituitary kapena pituitary apoplexy ndi matenda osowa koma owopsa. Ndi ngozi yachipatala yomwe imafuna chisamaliro choyenera.

Tanthauzo

Pituitary apoplexy ndi matenda a mtima kapena kutaya magazi komwe kumachitika mu pituitary adenoma (chotupa choopsa, chosakhala ndi khansa chomwe chimachokera ku pituitary gland mu ubongo). Oposa theka la milandu, apoplexy imasonyeza adenoma yomwe sinapereke zizindikiro zilizonse.

Zimayambitsa 

Zomwe zimayambitsa pituitary apoplexy sizikudziwika bwino. Pituitary adenomas ndi zotupa zomwe zimatuluka magazi kapena kufa mosavuta. Necrosis ikhoza kukhala chifukwa cha kuchepa kwa vascularization. 

matenda

Kujambula kwadzidzidzi (CT kapena MRI) kumapangitsa kuti adziwe matendawa posonyeza adenoma panthawi ya necrosis kapena kutaya magazi. Magazi achangu amatengedwanso. 

Anthu okhudzidwa 

Pituitary apoplexy imatha kuchitika pazaka zilizonse koma imapezeka kwambiri muzaka zitatu. Amuna amakhudzidwa pang'ono kuposa akazi. Pituitary apoplexy imakhudza 3% ya anthu omwe ali ndi pituitary adenoma. Mu milandu yopitilira 2/3, odwala samazindikira kukhalapo kwa adenoma yawo isanachitike vuto lalikulu. 

Zowopsa 

Anthu omwe ali ndi vuto la pituitary adenoma nthawi zambiri amakhala ndi zinthu zomwe zimapangitsa kuti ziwonjezeke kapena zomwe zimapangitsa kuti ziwonjezeke: kumwa mankhwala ena, kuyezetsa magazi, matenda omwe ali pachiwopsezo chachikulu (matenda a shuga, mayeso a angiographic, kukomoka, anti-coagulation, kuyesa kwa pituitary stimulation, radiotherapy, mimba, chithandizo ndi bromocriptine, isorbide. , chlorpromazine ...)

Komabe, ambiri a sitiroko zimachitika popanda precipitating factor.

Pituitary kapena pituitary apoplexy ndi kuphatikiza kwa zizindikiro zingapo, zomwe zimatha kuwoneka pakapita maola kapena masiku. 

litsipa 

Mutu waukulu ndi chizindikiro choyamba. Mutu wofiirira umapezeka mu milandu yopitilira katatu. Iwo akhoza kugwirizana ndi nseru, kusanza, kutentha thupi, kusokonezeka kwa chikumbumtima, motero kukwaniritsa meningeal syndrome. 

Zosokoneza zowoneka 

Kuposa theka la milandu ya pituitary apoplexy, kusokonezeka kwa maso kumagwirizanitsidwa ndi mutu. Izi ndikusintha kwa magawo owonera kapena kuwonongeka kwa mawonekedwe. Chodziwika kwambiri ndi bitemporal hemianopia (kutayika kwa gawo loyang'ana mbali zina za gawo lowonera). Kufa kwa Oculomotor kumakhalanso kofala. 

Zizindikiro za endocrine 

Pituitary apoplexy nthawi zambiri imatsagana ndi kuperewera kwa pituitary (hypopituitarism) komwe sikumakwanira nthawi zonse.

Utsogoleri wa pituitary apoplexy ndi wosiyanasiyana: ophthalmologists, neuroradiologists, neurosurgeons ndi endocrinologists. 

Chithandizo cha apoplexy nthawi zambiri chimakhala chachipatala. Hormonal substitution imayendetsedwa kuti ikonze vuto la endocrinological: chithandizo cha corticosteroid, chithandizo cha mahomoni a chithokomiro. Kutsitsimula kwa hydroelectrolytic. 

The apoplexy ikhoza kukhala mutu wa chithandizo chamankhwala a neurosurgical. Izi cholinga chake ndikuchepetsa zomanga zam'deralo makamaka njira zowonera. 

Thandizo la Corticosteroid ndilokhazikika, kaya aplexy amathandizidwa ndi neurosurgery kapena kuyang'aniridwa popanda opaleshoni (makamaka mwa anthu omwe alibe zowona kapena zowona komanso opanda chidziwitso). 

Pamene kulowererako kuli kofulumira, kuchira kwathunthu kumatheka, pamene kuchedwa kwachirendo kungakhale khungu lokhazikika kapena hemianopia. 

M'miyezi yotsatira ya apoplexy, kuwunikanso ntchito kwa pituitary kumachitika, kuti awone ngati pali zofooka zokhazikika za pituitary.

Sizotheka kwenikweni kupewa pituitary apoplexies. Komabe, musanyalanyaze zizindikiro zomwe zingakhale za pituitary adenoma, makamaka kusokonezeka kwa maso (adenomas imatha kufinya mitsempha ya maso). 

Kudulidwa kwa adenoma kumateteza gawo lina la pituitary apoplexy. (1)

(1) Arafah BM, Taylor HC, Salazar R., Saadi H., Selman WR Apoplexy wa pituitary adenoma pambuyo poyesedwa mwamphamvu ndi gonadotropin-release hormone Am J Med 1989; 87: 103-105