Pituitary Apoplexy, an Endocrinological Emergency: Case Report

Pituitary Apoplexy, an Endocrinological Emergency: Case Report

Author Info

Corresponding Author
Juliany Lourenço
Centro Universitário do Planalto Central Apparecido dos Santos, Gama, Distrito Federal, Brazil


Pituitary apoplexy is a rare endocrine emergency that can occur due to bleeding or ischemia in the pituitary gland. Its incidence can vary between 0.6% and 16.8% in the general population (2-7% in pituitary adenomas). We herein report an unusual case of a 50-year-old female patient who presented to the emergency with complaints of left hemicranial headache, cervicalgia, shoulder pain and dizziness for 1 year worsened in the last three days. Her prolactin levels were high, and the first imaging exam suggested a silent apoplexy, since the clinical picture of the patient did not indicate such condition. In the second one, the patient presented a typical picture of apoplexy, including intense headache and nausea. Her temporal evolution suggested a macroprolactinoma with hemorrhagic degeneration or apoplexy. As she did not present signs of indication for transsphenoidal emergency surgery, conservative treatment was chosen. In this case, due to history of repeated apoplexy, nausea and intense headache, it is important to keep close monitoring for an eventual urgent surgical intervention in case of new bleeding, visual alterations and/or reduced level of consciousness, since these are indicative signs for transsphenoidal emergency surgery.

Article Info

Article Type
Case Report
Publication history
Received: Tue 01, Dec 2020
Accepted: Tue 29, Dec 2020
Published: Thu 31, Dec 2020
© 2021 Juliany Lourenço. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository. All rights reserved.
DOI: 10.31487/j.SCR.2020.12.22