Pituitary apoplexy
Thunderclap headache with visual loss or ophthalmoplegia from bleeding into a pituitary adenoma. Give hydrocortisone, get an MRI, and choose surgery or watchful care by vision and consciousness.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Sudden haemorrhage or infarction of a pituitary tumour, usually a non-functioning macroadenoma that nobody knew about.
- Sudden severe headache plus visual loss, ophthalmoplegia or reduced consciousness. It mimics subarachnoid haemorrhage.
- The early killer is acute ACTH deficiency. Give hydrocortisone before the diagnosis is confirmed if the patient is unwell.
Loading the rest of the note…
Finished reading?
Sources
- UK guidelines for the management of pituitary apoplexySociety for Endocrinology (Rajasekaran et al., Clin Endocrinol 2011;74:9-20), 2011
- Hormonal replacement in hypopituitarism in adults: an Endocrine Society clinical practice guidelineEndocrine Society (Fleseriu et al., J Clin Endocrinol Metab 2016;101:3888-921), 2016
- Endocrinology (Therapeutic Guidelines)AU/NZTherapeutic Guidelines Ltd
- Assessing fitness to drive for commercial and private vehicle drivers (vision and eye disorders chapter)AU/NZAustroads and National Transport Commission
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy