Pseudo-pituitary enlargement (a push-up phenomenon)

Case contributed by Chris O'Donnell


Investigation of headaches. Said to have an enlarged pituitary on CT brain.

Patient Data

Age: 90 years
Gender: Female

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!

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