Serious Symptoms Of Pituitary Apoplexy

Pituitary apoplexy is a rare condition that develops as a result of bleeding into the pituitary gland, and it may also develop if blood circulation to the gland is blocked. The most frequent cause of pituitary apoplexy is bleeding within a benign tumor on the pituitary gland. Larger pituitary tumors increase the risk of pituitary apoplexy. Rarely, patients without pituitary tumors may develop pituitary apoplexy, and risk factors for this situation include diabetes, head injuries, radiation to the pituitary gland, and the use of a breathing machine. To diagnose pituitary apoplexy, patients will need to have an MRI or CT scan, and an eye exam might be performed as well. Several blood tests will be necessary to measure levels of growth hormone, cortisol, adrenocorticotropic hormone, IGF-1, and luteinizing hormone, and urine tests might be done to check for osmolarity. 

Cases of acute pituitary apoplexy may be life-threatening, and immediate surgery is normally performed to relieve pressure on the pituitary gland. Patients may also be given immediate treatment with adrenal replacement hormones. In non-urgent or chronic cases of pituitary apoplexy, surgery may be recommended only in instances where the condition is causing vision loss. In addition to adrenal replacement hormones, patients might also need hormone replacement for thyroid hormone, growth hormone, and sex hormones such as testosterone and estrogen. Untreated pituitary apoplexy may lead to vision loss and an adrenal crisis.

Sudden And Severe Headache

Patients with pituitary apoplexy may develop a sudden and severe headache as pressure builds up in the space surrounding the pituitary gland. Many individuals describe this headache as the worst of their lives, and some have described it as a thunderclap. Patients may notice severe pain on one or both sides of their head, and there may be a sharp, throbbing, or stabbing pain in the head that radiates down to the neck. 

Emergency medical care is necessary for these types of headaches, and doctors may need to perform CT scans, MRI scans, blood tests, or lumbar punctures to determine the underlying cause of the headache. If scans detect bleeding on the pituitary gland, the patient's care is normally handled by a neurosurgeon. Patients will be given pain relief at the hospital, and the neurosurgeon will discuss next steps, including potential surgery.