Endocrine Abstracts

Introduction: Pituitary apoplexy is caused by an infarction or a haemorrhage in a pituitary adenoma manifesting in acute headaches, consciousness impairment, endocrine features, and moderate to severe visual loss, with chiasmal syndrome or oculomotor palsies.

Case report: We describe here a case of a 25 years old woman, followed in our institute for a Cushing disease, and who underwent a pituitary apoplexy 24 h after a standard low-dose dexamethasone suppression test. In fact our patient presented a clinical outcome of a intra cranial hypertension, made of headache, vomiting associated to a loss of visual field and oculomotor palsies. MRI demonstrated classical signs of apoplexia. Patient was treated by cortico-therapy for one week with no response, leading to a surgical management. After what we could rapidly appreciate an improvement in the visual symptoms.

Conclusion: The clinical picture of pituitary apoplexy is characterized by the sudden onset of oculomotor palsy or blindness with acute headaches and even consciousness impairment. A functional and vital risk is present because of acute hypopituitarism. This emergency diagnosis is confirmed by tomodensitometry or magnetic resonance imaging. The association of hormone substitution and tumour transsphenoidal resection commonly leads to a positive outcome and visual improvement.