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Kasl RA, Kistka HM, Turner JH, et al. Pituitary Apoplexy After Intravitreal Injection of Vascular Endothelial Growth Factor Inhibitor: A Novel Complication. J Neurol Surg Rep. 2015;76(2):e205-10doi: 10.1055/s-0035-1554909.
Kasl, R. A., Kistka, H. M., Turner, J. H., Devin, J. K., & Chambless, L. B. (2015). Pituitary Apoplexy After Intravitreal Injection of Vascular Endothelial Growth Factor Inhibitor: A Novel Complication. Journal of neurological surgery reports, 76(2), e205-10. https://doi.org/10.1055/s-0035-1554909
Kasl, Rebecca A, et al. "Pituitary Apoplexy After Intravitreal Injection of Vascular Endothelial Growth Factor Inhibitor: A Novel Complication." Journal of neurological surgery reports vol. 76,2 (2015): e205-10. doi: https://doi.org/10.1055/s-0035-1554909
Kasl RA, Kistka HM, Turner JH, Devin JK, Chambless LB. Pituitary Apoplexy After Intravitreal Injection of Vascular Endothelial Growth Factor Inhibitor: A Novel Complication. J Neurol Surg Rep. 2015 Nov;76(2):e205-10. doi: 10.1055/s-0035-1554909. Epub 2015 Aug 24. PMID: 26623228; PMCID: PMC4648717.
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J Neurol Surg Rep. 2015 Nov;76(2):e205-10. doi: 10.1055/s-0035-1554909. Epub 2015 Aug 24.

Pituitary Apoplexy After Intravitreal Injection of Vascular Endothelial Growth Factor Inhibitor: A Novel Complication.

Journal of neurological surgery reports

Rebecca A Kasl, Heather M Kistka, Justin H Turner, Jessica K Devin, Lola B Chambless

Affiliations

  1. Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee, United States.
  2. Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee, United States.
  3. Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, United States.
  4. Division of Neurological Surgery, Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee, United States.

PMID: 26623228 PMCID: PMC4648717 DOI: 10.1055/s-0035-1554909

Abstract

Pituitary adenomas are common in the general population. They can be complicated by intratumoral hemorrhage, otherwise known as apoplexy, which frequently presents with neurologic deficits that may necessitate urgent surgical decompression. Many risk factors for pituitary apoplexy have been suggested in the literature. We present a case of symptomatic apoplexy in a woman following the intravitreal administration of the vascular endothelial growth factor (VEGF) inhibitor ranibizumab. Ophthalmoplegia resolved and visual acuity significantly improved following gross total resection of the tumor via an endoscopic endonasal surgical approach. The association between intravitreal injection of a VEGF inhibitor and pituitary apoplexy has not been previously described, but physicians performing these procedures should be aware of this potential complication.

Keywords: hemorrhage; pituitary apoplexy; ranibizumab; vascular endothelial growth factor inhibitor

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