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 Missouri Resident Poster Competition 1999 Motaz Alshaher M.D. St.
Luke’s Medical Center Pituitary apoplexy is a rare disease resulting from hemorrhage
into a pituitary tumor. It characteristically presents as a sudden
onset of headache, partial ophthalmoplegia and blindness. We present a 43 year-old female who came in with nausea,
vomiting, generalized headache and neck stiffness for two days prior
to admission. Lumbar puncture yielded a turbid CSF with 1360 WBCs
(88% seg) and 210 RBCs, 73 glucose and 191 protein. The patient was
treated initially with IV antibiotics for possible bacterial
meningitis until her CSF culture came negative. She was feeling
slightly better with improvement in her headache until the 5th
day of admission when she developed acute onset of bitemporal visual
field defects. MRI of the head revealed a suprasellar mass. The
patient underwent a left frontal craniotomy with subtotal removal of
the mass. Pathology later showed an acute hemorrhagic infarction of
a pituitary adenoma. Conclusion: Pituitary apoplexy should be considered in the
differential diagnosis of "aseptic meningitis". |
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