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Complications of Orthopaedic Surgery

Goel V, Debnath UK, Singh J et al. J Arthrop 2009;24:826.e7–10.

The authors describe two cases of pituitary apoplexy after joint replacement surgery in this article.

 

Pituitary apoplexy (PA) is a rare complication of pituitary adenoma. The pathogenesis of PA is still undefined, but it is likely that abnormal vascularization of an adenoma predisposes a patient to an ischemic event. Hypotension or microthrombi may be the precipitating factors. PA is a potentially life-threatening complication. Patients with PA usually have headache and visual disturbances (reduced vision acuity and/or field). Ocular palsy, nausea and vomiting, altered mental state, and hemiparesis may occur. In addition, an enlarged adenoma may compress the cavernous sinus and neurovascular bundle.

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