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Pituitary Apoplexy Masquerading as Meningoencephalitis
Author(s) -
Jassal Davinder S.,
McGinn Gregory,
Embil John M.
Publication year - 2004
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1111/j.1526-4610.2004.04013.x
Subject(s) - pituitary apoplexy , medicine , meningoencephalitis , etiology , differential diagnosis , meningitis , subarachnoid hemorrhage , cerebrospinal fluid , pathology , surgery , pituitary adenoma , adenoma
Background.—Pituitary apoplexy, a rare but life‐threatening disorder, is characterized by the abrupt destruction of pituitary tissue secondary to infarction or hemorrhage of the gland itself. Its clinical features include severe headache, stiff neck, fever, visual disturbances, and symptoms of hypoadrenalism. Objective.—To assess how pituitary apoplexy may mimic the clinical findings of an infectious meningoencephalitis. Methods and Results.—We describe 3 individuals whose clinical profile and paraclinical studies were consistent with a diagnosis of presumed infectious meningoencephalitis. With minimal improvement on antimicrobial therapy, however, an extensive clinical and radiographic reevaluation yielded pituitary apoplexy as the etiology of their acute neurologic event. Conclusion.—Pituitary apoplexy is often misdiagnosed as meningitis or subarachnoid hemorrhage due to the presence of leukocytes and erythrocytes in the cerebrospinal fluid. These cases serve to highlight the importance of maintaining a broad differential diagnosis when evaluating patients presenting with an acute headache.