Presentation
Acute onset of headaches and right oculomotor palsies.
Patient Data
Lobulated mass enlarging the pituitary fossa of intermediate signal intensity on T1 and T2, containing areas of high signal on T1 and hyposignal T2 (hemorrhagic necrosis). The postcontrast sequences show a heterogeneous enhancement mainly peripheral. It shows a superior extension filling the suprasellar cistern and compressing the optic chiasma which is displaced superiorly, inferior extension filling the sphenoid sinuses, and lateral extension to the right cavernous sinus, encasing the internal carotid artery which shows reduced caliber as compared to the left (well-visualized on coronal sequences).
Case Discussion
Pituitary apoplexy is potentially life-threatening endocrine and neurosurgical emergency. It corresponds to a hemorrhagic or non-hemorrhagic necrosis within pituitary macroadenoma . It's rarely seen within normal pituitary gland.
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