Neurosurgery: Neuroendocrine lesions
This chapter focuses on the characteristics of pituitary adenomas in elderly patients and anesthetic concerns of surgical resection of pituitary. The signs and symptoms of pituitary tumors in elderly patients are usually concealed by various comorbidities and physiological effects of aging that might delay the diagnosis. As a result of this, these patients commonly present with the symptoms of mass effect. The surgical resection of these tumors is associated with more complications due to the presence of associated comorbidities. Perioperative management of neuroendocrine tumors is quite challenging in elderly patients. Superiorly, the pituitary gland is connected to the hypothalamus via the pituitary stalk, passing through an opening in the diaphragmatic sella. The diagnosis of pituitary adenomas in elderly patient may be disguised by associated comorbid conditions and polypharmacy, and is usually missed more often than in younger adults.