Severe Headache and Acute Blindness: A Case of Pituitary Apoplexy

TL;DR

A case report describes a woman with pituitary apoplexy, highlighting the importance of early diagnosis and treatment to prevent severe complications.

Contribution

This case emphasizes the need for prompt recognition and management of pituitary apoplexy in patients with pituitary adenomas.

Findings

The patient regained partial vision after surgery but had no light perception in one eye.

Early diagnosis and treatment can reverse symptoms of pituitary apoplexy.

Patients with headaches and visual field defects should be screened for pituitary adenoma.

Abstract

Pituitary apoplexy is a rare, life‐threatening syndrome that commonly occurs in the adenomatous pituitary gland. It presents with a myriad of severe neuroendocrine and ophthalmological signs and symptoms. Early diagnosis and prompt treatment are vital in the management of pituitary apoplexy. This case report describes a 56‐year‐old woman who reported to the neurology clinic with 1 week's history of visual loss, and a severe headache, on the background of a 2‐year history of pituitary adenoma with poor follow‐up. The patient underwent transsphenoidal surgery. She regained vision in the right eye, but no perception of light in the left eye. Patients with headaches and impaired visual field should be screened for pituitary adenoma. Signs and symptoms may be reversible with early diagnosis and prompt treatment of pituitary apoplexy.

Clinicians should consider pituitary apoplexy a possibility in patients with pituitary adenoma, presenting with acute headaches and visual field defects. If detected early and treated promptly, the signs and symptoms of pituitary apoplexy may be reversible.

Figures