Presentation
Sudden onset of severe headaches with visual disturbances in pregnant patient at 28 week eeks known for pituitary mass with high prolactin level.
Patient Data
There is a large sellar mass with suprasellar extension filling the optochiasmatic cistern and elevating the optic chiasma with a right paracentral component of high signal on T1, low signal on T2 with blood-blood level well-visualized on FLAIR and GE sequences (hemorrhagic infarction).
Enhanced sequences were not performed (pregnant patient).
Case Discussion
The clinical presentation and the MRI features in a patient with a pre-existing pituitary macroadenoma are most consistent with pituitary apoplexy.
An existing pituitary macroadenoma is usually present (60-90%), but it has occurred with healthy glands in a few isolated cases.
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