• Wenfeng Ye, Wenjie Huang, Linlin Chen, Changfang Yao, Shiying Sheng, Zhengyu Liu, Chunyan Xue, and Wei Xing.
• Department of Obstetrics and Gynecology.
• Medicine (Baltimore). 2021 Mar 12; 100 (10): e25075e25075.

RationalePituitary tumor apoplexy (PTA) is a rare clinical syndrome which requires urgent diagnosis and treatment due to its life-threatening consequences. Management of undiagnosed pituitary tumor before pregnancy is a problem during pregnancy.Patient ConcernsWe reported a case with PTA which was not diagnosed before pregnancy presenting with vomiting associated with hyponatremia during the third trimester. After supplying the sodium the patient presented with dysarthria and hemiplegia.DiagnosesMRI examination showed PTA accompanied with extrapontine myelinolysis (EPM).InterventionsThe patient was given hydrocortisone according to the symptoms gradually to taper off dose, at the same times oral levothyroxine therapy (25μg/day) was given.OutcomesThe patient delivered a healthy baby via cesarean section at hospital at 38 + 1 week of gestation. We performed MRI examination regularly and the tumor regressed significantly 8 months postpartum.LessonsWe reported a case as PTA associated with EPM. Headache during pregnancy is often nonspecific, so careful medical history inquiry is very important.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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