Sudden Headache and Blindness Due to Pituitary (Adenoma) Infarction: A Case Report.

Cureus. 2019 Feb 13;11(2):e4059. doi: 10.7759/cureus.4059.

Dupont G, Lachkar S, Iwanaga J, Tubbs RS, Ishak B.

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Abstract

Pituitary infarction (PI) is a rare medical emergency appearing in patients with pituitary adenoma, presenting with sudden onset of severe headache, and often associated with vomiting, nausea, visual deterioration, and decreased consciousness. We describe an 83-year-old woman who presented with blindness after a history of severe headache. An urgent computed tomography (CT) scan of the brain had been arranged, and a massive pituitary adenoma with hemorrhage was observed, and admission to the neurosurgical department followed. A multidisciplinary team comprising a neurosurgeon, an ophthalmologist, and an endocrinologist is required to manage such cases. To confirm the diagnosis, an urgent magnetic resonance imaging (MRI) must be performed; CT scan can be indicated if MRI is contraindicated or not possible.

KEYWORDS:

opthalmoplegia; pituitary failure; pituitary infarction; sudden blindness

Figure 1

Gadolinium-enhanced T1-weighted magnetic resonance imaging (MRI) scans demonstrating a large pituitary macroadenoma with hemorrhage. Histology revealed pituitary (adenoma) infarction compressing the optic chiasm (white arrow). Axial (A), coronal (B), and sagittal (C) views of the brain.