الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
PA is a rare clinical syndrome that is common in pituitary macroadenomas. Patients with visual defects, ophthalmoplegia, and confusion usually require surgical treatment. We report the clinical presentations and outcomes of patients who underwent endoscopic endonasal trans-sphenoidal surgery for pituitary tumor apoplexy. Based on these results, our study supports the use of endoscopic trans-sphenoidal surgical intervention in the setting of acute apoplexy with neuro-ophthalmologic deficits, because most patients‘ symptoms improved postoperatively. Given our low rates of complications and recurrence, with a low morbidity rate. These findings support the belief that endoscopic endonasal trans-sphenoidal surgery is a safe and effective treatment for pituitary apoplexy. However, the high percentage of patients with panhypopituitarism postoperatively suggests that although surgery may be an effective means for improving symptoms of mass effect such as vision and headaches, it may not significantly improve endocrine function in the long-term. These results can be achieved by referring the patients to dedicated ter tiary pituitary centers experienced surgeons and endocrinologists for the most appropriate multidisciplinary management. Further research should be carried out to better identify risk factors that may predispose patients to pituitary apoplexy and to help triage patients with apoplexy who may have the most benefit from acute surgical intervention and a higher level of care.