A 56-year-old man with hypertension on lisinopril presents with severe frontal headache, neck stiffness, and sudden-onset bitemporal hemianopsia. Vital signs: BP 158/92 mmHg, HR 88/min, RR 16/min, Temp 37.2°C, SpO2 98% on room air. He is afebrile with normal CSF studies and no meningeal signs on repeat examination. Brain MRI reveals a 2-cm sellar mass with acute hemorrhage and compression of the optic chiasm. Which diagnosis best explains these findings?
- A)Pituitary apoplexyGABARITO
- B)Meningitis
- C)Acute ischemic stroke
- D)Acute angle-closure glaucoma
- E)Subarachnoid hemorrhage
Explicação
Pituitary apoplexy is acute hemorrhage or infarction of the pituitary gland, presenting with sudden severe headache, vision loss, ophthalmoplegia, and meningeal signs. It is a neurosurgical emergency requiring rapid imaging and often emergent transsphenoidal d... Ver explicação completa e trilha adaptativa →