Recognizing and intervening in pituitary apoplexy

Pituitary apoplexy is a rare and life-threatening disorder often requiring emergency neurosurgical intervention to preserve vision and prevent cerebral herniation syndrome. Infarction or hemorrhage of an enlarged pituitary gland or pituitary tumor is the most common cause of pituitary apoplexy. Early recognition of this disorder is essential for preventing permanent visual loss or death; however, pituitary apoplexy often mimics subarachnoid hemorrhage, which in some cases may delay definitive diagnosis. Multidisciplinary evaluation of these patients will determine the most appropriate emergency treatment plan and long-term management strategies. Advanced practice nurses can be instrumental in recognizing signs and symptoms of pituitary apoplexy and coordinating the immediate and ongoing evaluation and care.