• World Neurosurg · Jan 2017

    Case Reports

    Pituitary Apoplexy Mimicking Bacterial Meningitis with Intracranial Hypertension.

    • Bruno Law-Ye, Nadya Pyatigorskaya, and Delphine Leclercq.
    • Department of Neuroradiology, APHP, Pitié-Salpêtrière Hospital, Paris, France; Sorbonne Universités, Pierre and Marie Curie Faculty of Medicine, Paris, France. Electronic address: bruno.law-ye@aphp.fr.
    • World Neurosurg. 2017 Jan 1; 97: 748.e3-748.e5.

    Case DescriptionA 29-year-old patient experienced a violent headache during bodybuilding exercises. Brain magnetic resonance imaging revealed diffuse meningitis and a 38-mm necrotic pituitary adenoma. Meningoencephalitis was suspected but was ruled out by lumbar puncture. Rapid deterioration of the patient's condition led to coma and oxygen desaturation secondary to intracranial hypertension. Intense treatment for intracranial hypertension included profound sedation with respiratory assistance, osmotherapy, hypothermia, and external ventricular drainage. After 4 weeks in the intensive care unit, the patient fully recovered and was discharged with hormonal supplementation.ConclusionsThe few reported cases of pituitary apoplexy mimicking bacterial meningoencephalitis may have resulted from blood leakage or necrosis into the subarachnoid space.Copyright © 2016 Elsevier Inc. All rights reserved.

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