A 56-year-old man with a known pituitary macroadenoma presents with sudden severe frontal headache, vomiting, diplopia, and confusion. Vital signs show BP 156/92 mmHg, HR 78/min, RR 16/min, temperature 37.2°C. Physical examination reveals right ptosis and impaired abduction. Brain MRI demonstrates hemorrhage within the adenoma with mass effect on the cavernous sinus. Serum sodium is 138 mEq/L. Which complication best explains his acute neurologic deterioration?
- A)Subarachnoid hemorrhage from a berry aneurysm
- B)Cavernous sinus thrombosis from facial infection
- C)Acute bacterial meningitis
- D)Hemorrhagic infarction of a pituitary adenomaGABARITO
- E)Osmotic demyelination syndrome
Explicação
Pituitary apoplexy is hemorrhage or infarction within a pituitary adenoma. It presents with sudden headache, visual symptoms, ophthalmoplegia from cavernous sinus involvement, and acute hypopituitarism. A known macroadenoma with abrupt cranial nerve deficits s... Ver explicação completa e trilha adaptativa →