J Korean Soc Emerg Med.  2002 Mar;13(1):94-96.

Pituitary Apoplexy Presenting as Meningitis

Affiliations
  • 1Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Korea. ysjung@madang.ajou.ac.kr

Abstract

Pituitary apoplexy is an acute infarction of the pituitary gland and is a potentially life-threatening condition that may be highly variable in its clinical presentation. As pituitary apoplexy may be fatal in its fulminant state without neurological decompression and corticosteroid, the diagnosis must be made in the emergency department as soon as possible. During its progress, cranial nerves III, IV, V and VI can be compressed. As a result, various degrees of ocular palsy, opthalmoplegia, ptosis, visual field defects, and pupillary defects may be present. However, its diagnosis is very difficult when there are no neurologic symptoms. We report the case of a 58-year-old man presenting to the emergency department with a headache and a febrile sense which had been experienced for 2 days. He had no neurologic symptoms in the initial presentation, but the final diagnosis was pituitary apoplexy. This difficult case is described.

Keyword

Pituitary apoplexy; Headache

MeSH Terms

Cranial Nerves
Decompression
Diagnosis
Emergency Service, Hospital
Headache
Humans
Infarction
Meningitis*
Middle Aged
Neurologic Manifestations
Paralysis
Pituitary Apoplexy*
Pituitary Gland
Visual Fields
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