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Pituitary apoplexy

Case contributed by Frank Gaillard
Diagnosis probable

Presentation

Acute onset headache.

Patient Data

Age: Adult
mri

Intrinsic high T1 signal is seen in a pituitary mass which has remodeled the pituitary fossa. In this clinical context, features are consistent with pituitary apoplexy. 

Case Discussion

Pituitary apoplexy is an acute clinical syndrome caused by either hemorrhage or infarction of the pituitary gland. Although variable, it typically comprises of a headache, visual deficits, ophthalmoplegia, and altered mental status. An existing pituitary macroadenoma is usually present (60-90%) but it can occur with healthy glands in few isolated cases. 

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