J Korean Neurosurg Soc.  2003 Sep;34(3):249-251.

Pituitary Apoplexy Mimicking Aneurysmal Rupture of Anterior Communicating Artery

• Kim YG
• Lee JS
• Park MS
• Ha HG

Abstract

Pituitary apoplexy presenting with subarachnoid haemorrhage(SAH) is rare and thus may be easily mistaken for aneurysmal rupture. The authors report a case of pituitary apoplexy presented with SAH mimicking aneurysmal rupture of anterior communicating artery. A 70-year-old woman presented with sudden severe headache, vomiting and drowsiness. Computerized tomography showed diffuse SAH in basal cistern and enhancing sellar mass lesion that was overlooked. Because cerebral angiography showed a suspicious small aneurysmal sac at the origin of anterior communicating artery, we regarded it as an aneurysmal rupture. Craniotomy was performed but we could not find any aneurysm. There was a definite hemorrhagic mass lesion in the sellar and suprasellar area. Histopathological examination revealed a micronodular pituitary adenoma with hemorrhage. The authors stress that pituitary apoplexy must be included in the differential diagnosis of SAH, and proper preoperative radiologic imaging and careful interpretation is demanding for rule out the possibility of pituitary apoplexy.

Keyword

Pituitary apoplexy; Subarachnoid hemorrhage; Anterior communicating artery; Aneurysm

MeSH Terms

Aged
Aneurysm*
Arteries*
Cerebral Angiography
Craniotomy
Diagnosis, Differential
Female
Headache
Hemorrhage
Humans
Pituitary Apoplexy*
Pituitary Neoplasms
Rupture*
Sleep Stages
Subarachnoid Hemorrhage
Vomiting