I-pituitary noma i-pituitary apoplexy yisifo esingavamile kodwa esibucayi. Kuyisimo esiphuthumayo sezokwelapha esidinga ukuphathwa okufanele.

Incazelo

I-pituitary apoplexy isifo senhliziyo noma ukopha okwenzeka ku-pituitary adenoma (isimila se-endocrine esiyingozi, esingenawo umdlavuza esivela ku-pituitary gland ebuchosheni). Ezimweni ezingaphezu kwesigamu, i-apoplexy yembula i-adenoma engazange inikeze izimpawu.

Izimbangela 

Izimbangela ze-pituitary apoplexy aziqondi ngokugcwele. I-pituitary adenomas yizimila ezopha noma ezifa kalula. I-necrosis kungenzeka ngenxa yokuntuleka kwe-vascularization. 

kwesifo

I-imaging Emergency (CT noma i-MRI) yenza kube lula ukwenza ukuxilongwa ngokubonisa i-adenoma ohlelweni lwe-necrosis noma ukopha. Amasampula egazi aphuthumayo nawo ayathathwa. 

Abantu abathintekayo 

I-pituitary apoplexy ingenzeka kunoma ibuphi ubudala kodwa ivame kakhulu eminyakeni engu-3 yakho. Abesilisa bathinteka kancane kunabesifazane. I-pituitary apoplexy ithinta u-2% wabantu abane-pituitary adenoma. Ezimweni ezingaphezu kuka-3/XNUMX, iziguli aziboni ukuba khona kwe-adenoma yazo ngaphambi kwenkinga enkulu. 

Izici zengozi 

Abantu abane-pituitary adenoma bavame ukuba nezici ezibabangelayo noma ezibabangelayo: ukuphuza imithi ethile, ukuhlolwa okuhlaselayo, izifo eziyingozi kakhulu (isifo sikashukela i-mellitus, ukuhlolwa kwe-angiographic, ukuphazamiseka kwe-coagulation, i-anti-coagulation, i-pituitary stimulation test, i-radiotherapy, ukukhulelwa, ukwelashwa nge-bromocriptine, i-isorbide. , i-chlorpromazine ...)

Kodwa-ke, iningi lemivimbo lenzeka ngaphandle kwe-precipitating factor.

I-pituitary noma i-pituitary apoplexy iyinhlanganisela yezimpawu ezimbalwa, ezingavela phakathi namahora noma izinsuku. 

Ukuphathwa yikhanda 

Ikhanda elibuhlungu elibuhlungu liwuphawu lokuqala. Ikhanda elibomvu likhona ezimweni ezingaphezu kwezine ezintathu. Zingahlotshaniswa nokucanuzela kwenhliziyo, ukuhlanza, umkhuhlane, ukuphazamiseka kokuqaphela, ngaleyo ndlela kuzuzwe i-meningeal syndrome. 

Ukuphazamiseka okubonakalayo 

Ezimweni ezingaphezu kwesigamu se-pituitary apoplexy, ukuphazamiseka okubukwayo kuhlotshaniswa nekhanda elibuhlungu. Lokhu ukuguqulwa kwenkundla yokubuka noma ukulahleka kokubona kahle. Okuvame kakhulu i-hemianopia ye-bitemporal (ukulahlekelwa inkambu yokubuka esemaceleni ezinhlangothini ezihlukene zenkundla yokubuka). Ukukhubazeka kwe-Oculomotor nakho kuvamile. 

Izimpawu ze-endocrine 

I-pituitary apoplexy ivame ukuhambisana nokushoda kwe-pituitary acute (hypopituitarism) okungahlali kuphelele.

Ukuphathwa kwe-pituitary apoplexy kunezindlela eziningi: ophthalmologists, neuroradiologists, neurosurgeons kanye ne-endocrinologists. 

Ukwelashwa kwe-apoplexy kuvame ukuba yizokwelapha. I-Hormonal substitution isetshenziswa ukulungisa ukushoda kwe-endocrinological: ukwelashwa kwe-corticosteroid, ukwelashwa kwe-hormone yegilo. I-hydro-electrolytic resuscitation. 

I-apoplexy ingaba isihloko sokwelashwa kwe-neurosurgical. Lokhu kuhloswe ngakho ukunciphisa izakhiwo zendawo futhi ikakhulukazi izindlela zokubona. 

Ukwelashwa kwe-Corticosteroid kuhlelekile, kungakhathaliseki ukuthi i-aoplexy yelashwa nge-neurosurgery noma iqashwe ngaphandle kokuhlinzwa (ikakhulukazi kubantu abangenayo indawo yokubukwayo noma ukuphazamiseka kokubona futhi abangenakho ukonakala kokwazi). 

Uma ukungenelela kushesha, ukululama okuphelele kungenzeka, kanti uma kwenzeka ukubambezeleka kokwelapha kungase kube nobumpumputhe obuhlala njalo noma i-hemianopia. 

Ezinyangeni ezilandela i-apoplexy ukuhlolwa kabusha komsebenzi we-pituitary kuyenziwa, ukuze kubonakale ukuthi kukhona yini ukulahlekelwa okungapheli kwe-pituitary.

Akunakwenzeka ngempela ukuvimbela i-pituitary apoplexies. Kodwa-ke, akufanele uzibe izimpawu ezingase zibe yilezo ze-pituitary adenoma, ikakhulukazi ukuphazamiseka okubukwayo (i-adenomas ingacindezela imizwa yamehlo). 

Ukukhishwa ngokuhlinzwa kwe-adenoma kuvimbela esinye isiqephu se-pituitary apoplexy. (1)

(1) U-Arafah BM, u-Taylor HC, u-Salazar R., u-Saadi H., u-Selman WR Apoplexy we-pituitary adenoma ngemva kokuhlolwa okunamandla nge-hormone ekhulula i-gonadotropin Am J Med 1989; 87: 103-105