Pituitary kana pituitary apoplexy chirwere chisingawanzoitiki asi chakakomba. Injodzi yekurapa inoda kutungamira kwakakodzera.

tsananguro

Pituitary apoplexy chirwere chemoyo kana kubuda ropa kunoitika mupituitary adenoma (bundu risina kenza, risina kenza rinobva mupituitary gland muuropi). Munopfuura hafu yezviitiko, apoplexy inoratidza adenoma iyo isina kupa chero zviratidzo.

Zvinokonzera 

Zvikonzero zvepituitary apoplexy hazvinzwisiswi zvizere. Pituitary adenomas mamota anobuda ropa kana kufa zviri nyore. Iyo necrosis inogona kunge iri nekuda kwekushomeka kwevascularization. 

chirwere

Emergency imaging (CT kana MRI) inoita kuti zvikwanise kuita kuti kuongororwa nekuratidza adenoma mukugadzirisa necrosis kana kubuda ropa. Maekiseni eropa echimbichimbi anotorwawo. 

Vanhu vane hanya 

Pituitary apoplexy inogona kuitika chero zera asi inowanzoitika muma3s ako. Varume vanobatwa zvishoma pane vakadzi. Pituitary apoplexy inobata 2% yevanhu vane pituitary adenoma. Mune anopfuura 3/XNUMX ezviitiko, varwere havazive kuvepo kweadenoma yavo isati yanyanya complication. 

Zvinhu zvinotyisa 

Vanhu vane pituitary adenoma vanowanzova ne predisposing kana precipitating factor: kutora mamwe madhiragi, kuongororwa kwevasina njodzi, njodzi yakanyanya (diabetes mellitus, angiographic examinations, coagulation disorders, anti-coagulation, pituitary stimulation test, radiotherapy, nhumbu, kurapwa nebromocriptine, isorbide. , chlorpromazine ...)

Nekudaro, ruzhinji rwekurohwa kunoitika pasina precipitating factor.

Pituitary kana pituitary apoplexy musanganiswa wezviratidzo zvakati wandei, zvinogona kuoneka kwemaawa kana mazuva. 

Headaches 

Kutemwa nemusoro kwakanyanya chiratidzo chekutanga. Musoro wepepuru unowanikwa mune zvinopfuura zvikamu zvitatu zvezviitiko. Vanogona kubatanidzwa nekusvotwa, kurutsa, fivha, kuvhiringidzika kwekuziva, nokudaro kuwana meningeal syndrome. 

Kuvhiringidzika kunoonekwa 

Muchikamu chinopfuura hafu yezviitiko zvepituitary apoplexy, kuvhiringidzika kwekuona kunobatanidza nemusoro. Aya ndiwo machinjiro enzvimbo yekuona kana kurasikirwa kwekuona acuity. Inonyanya kuzivikanwa ndeye bitemporal hemianopia (kurasikirwa kwe lateral yekuona munda kune mativi akapesana enzvimbo yekuona). Oculomotor paralysis inowanzoitika. 

Endocrine zviratidzo 

Pituitary apoplexy inowanzoperekedzwa neacute pituitary insufficiency (hypopituitarism) iyo isiri nguva dzose yakakwana.

Kutungamirirwa kwepituitary apoplexy kune zvakasiyana-siyana: ophthalmologists, neuroradiologists, neurosurgeons uye endocrinologists. 

Kurapa kweapoplexy kunowanzoita zvekurapa. Hormonal substitution inoshandiswa kugadzirisa kusakwana kwe endocrinological: corticosteroid therapy, thyroid hormone therapy. A hydro-electrolytic resuscitation. 

Iyo apoplexy inogona kunge iri nyaya yekurapa neurosurgical. Izvi zvinovavarira kuderedza zvimiro zvenzvimbo uye kunyanya nzira dzemaziso. 

Corticosteroid therapy inorongwa, ingave iyo aplexy inorapwa neurosurgically kana kutariswa pasina kuvhiyiwa (kunyanya kune vanhu vasina nzvimbo yekuona kana kuona acuity kusagadzikana uye pasina kukanganisa kwekuziva). 

Kana kupindira kuchikurumidzira, kupora zvachose kunokwanisika, asi kana chiitiko chekunonoka kwekurapa kunogona kuva nehupofu husingagumi kana hemianopia. 

Mumwedzi inotevera apoplexy kuongororwazve kwepituitary basa kunoitwa, kuitira kuti uone kana pane zvachose pituitary deficits.

Hazvibviri chaizvo kudzivirira pituitary apoplexies. Nekudaro, haufanirwe kufuratira zviratidzo zvinogona kunge zviri zvepituitary adenoma, kunyanya kuvhiringika kwekuona (adenomas inogona kudzvanya tsinga dzemaziso). 

Kuvhiya kubviswa kweadenoma kunodzivirira chimwe chikamu chepituitary apoplexy. (1)

(1) Arafah BM, Taylor HC, Salazar R., Saadi H., Selman WR Apoplexy yepituitary adenoma mushure mekuedzwa zvine simba negonadotropin-inoburitsa hormone. Am J Med 1989; 87: 103-105