Some patients (especially the ones with microadenomas) may present with an acute clinical picture characterized with headache, vomiting, loss of vision, ophthalmoplegia and clouding of consciousness due to pituitary apoplexy
which is a rare condition (4).
can mimic acute meningoencephalitis or subarachnoid haemorrhage Int J Emerg Med.
UK Guidelines for the management of Pituitary Apoplexy
MRI is better for diagnosis and should be done in all cases of suspected pituitary apoplexy
following an initial CT scan.
A final diagnosis of acute pituitary apoplexy
complicating a pituitary macro-adenoma was made.
Similarly clinical features has a spectrum including visual disturbance, headache, pituitary apoplexy
, acromegaly, hypothyroidism, short stature, menstrual disturbance and others, making the diagnosis challenging.
In a previous series of patients presenting with pituitary apoplexy
, intrasellar hemorrhage was not recognized on initial NCT in the majority of cases, although intrasellar tumors were visible in almost all cases on NCT.
Causes of intracranial haemorrhage Intracerebral haematoma Subarachnoid haemorrhage Hypertensive haemorrhage Aneurysm Amyloid angiopathy Peri-mesencephalic bleed Arterio-venous malformation Arterio-venous malformation Aneurysmal haemorrhage Pituitary apoplexy
Haemorrhagic tumour Drug abuse Dural sinus fistula Anticoagulant drugs Infarct with haemorrhagic Pituitary apoplexy
transformation Venous infarct with Anticoagulant drugs haemorrhagic transformation
Pituitary Abscess with Panhypopituitarism Showing T1 Signal Hyperintensity of the Marginal Pituitary Area: A Non-invasive Differential Diagnosis of Pituitary Abscess and Pituitary Apoplexy
Surgery is also recommended when the incidentaloma is abutting or compressing the optic nerves or chiasm on magnetic resonance imaging, when a patient is experiencing pituitary apoplexy
with visual disturbance, or if a patient has a hypersecreting tumor other than a prolactinoma, according to the guidelines, which appear in the Endocrine Society's journal (J.
is a rare clinical syndrome characterized by sudden onset of headache and vomiting, accompanied by visual disturbance or ocular motility impairment and some degree of pituitary insufficiency (1).