Guk M. Pituitary adenomas with apoplectic course: diagnosis and surgical treatment.

Dissertation deals with the problem of improvement of diagnosis and surgical treatment for pituitary adenomas with apoplectic course (also called "pituitary apoplexy", PA) We investigated cases of 92 patients with PA operated in 1996 - 2006 in Institute of Neurosurgery, Kyiv, Ukraine. Among them women - 45, men - 47, average age was 43.7 years . We considered PA only in patients with acute onset of disease and intratumoral changes of haemorrhagic or necrotic kind, founded out on surgery.It was found that generally diagnostic problems of PA lead to late and inadequate treatment of those patients in Ukraine.A lot differences in clinical course, visual and oculomotor disturbances, endocrine manifestations, diagnostic methods between classic pituitary adenoma and one with apoplectic course were found. It was also shown necessarily to assess in time and adequately correct the pituitary insufficiency in patients with PA. Transsphenoidal decompression was found the most safe and effective treatment against the PA (except little number of patients with contraindications for transsphenoidal surgery). Best results were obtained with one week from the onset of the disease. The results of this research work have found application in neurosurgical practice.