Pituitary apoplexy

Case contributed by Dr Abdallah Khateeb

Presentation

Acute on top of chronic headache. Known to have bitemporal hemianopsia previously.

Patient Data

Age: 40 years
Gender: Male
Modality: MRI

There is a large mass, centered at the sella, expanding the bony sella into the sphenoid sinuses, extending superiorly to fill the suprasellar cistern. The optic chiasm is obviously compressed superiorly and explains the patient's visual complaint. Also it goes posteriorly and causes splaying of the cerebral peduncles.

Different signal intensities are obtained from this lesion. Peripherally, it's slightly hyper intense on T1 and T2 images and enhances following contrast administration. Centrally, there is a large fluid-blood level, consistent with an acute hemorrhagic process into this mass.

Case Discussion

This is a case of pituitary macroadenoma, complicated by pituitary apoplexy, which is a clinical syndrome of headache, visual defects, altered mental status usually due to the acute enlargement of a pituitary macroadenoma by bleeding. 

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Case Information

rID: 44911
Case created: 8th May 2016
Last edited: 7th Apr 2017
Inclusion in quiz mode: Included

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