Presentation
Investigation of headaches. Said to have an enlarged pituitary on CT brain.
Patient Data
Age: 90 years
Gender: Female
From the case:
Pseudo-pituitary enlargement (a push-up phenomenon)
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Coronal T1
Ectatic and tortuous internal carotid arteries encroaching on the sella, extrinsically compressing the pituitary from side to side and causing it to appear enlarged on the sagittal projection (with an upward convexity)
Case Discussion
This is an unusual cause for an "enlarged pituitary". Importance of the case is the exclusion of substantial pathology and a warning to the neurosurgeon not to attempt transsphenoidal surgery for risk of torrential bleeding!