Pituitary apoplexy history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Akshun Kalia M.B.B.S.[2]

Symptoms

Pituitary infarction usually has a short period of symptoms (acute), but it can be life-threatening.

Symptoms usually include:

• Severe headache. It is generally the first symptom to appear (seen in 80% of patients).
• Paralysis of the eye muscles (ophthalmoplegia), causing double vision (diplopia) . It can be due to intracavernous expansion of the tumor mass or a sudden increase of pressure in the pituitary region.
• Visual disturbances from compression of surrounding structures (optic chiasm and optic tract).
• Extravasation of blood into subarachnoid space can lead to signs of meningeal irritation such as nausea, vomitting, photophobia and meningismus.,
• Low blood pressure, nausea, and vomiting from acute adrenal insufficiency

Less commonly, pituitary dysfunction may appear more slowly. In Sheehan syndrome, for example, the first symptom may be a failure to produce milk caused by lack of the hormone prolactin.

Over time, problems with other pituitary hormones may develop, causing symptoms of the following conditions:

• Growth hormone deficiency
  • Fatigue
  • Increased fat in the abdomen
  • Lack of energy
• Hypoadrenalism (if not already present or treated)
  • Inability to deal with physical stress
  • Nausea
• Hypogonadism
  • Absent periods (amenorrhea) in women
  • Sexual dysfunction and loss of muscle mass in men
• Hypothyroidism
  • Cold intolerance
  • Constipation
  • Depressed mood
  • Dry skin
  • Fatigue
  • Hair or skin changes
  • Hoarseness
  • Menstrual changes
  • Mental slowing
  • Weight gain

When the posterior pituitary is involved (rare), symptoms may include:

• Failure of the uterus to contract as needed to give birth to a baby (in women)
• Failure to produce breast milk (in women)
• Uncontrolled urination