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Pituitary infarction

  • Alternative Names

    Pituitary apoplexy


    Symptoms

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

    Symptoms usually include:

    • Severe headache
    • Paralysis of the eye muscles, causing double vision (ophthalmoplegia)
    • 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 a 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

    Signs and tests

    Signs of acute pituitary infarction may include:

    • Low blood pressure
    • Visual field defects

    Signs of chronic pituitary insufficiency include:

    • Growth hormone deficiency
      • Loss of muscle mass
      • Problems with fat metabolism (dyslipidemia)
    • Hypoadrenalism
      • Low blood pressure
      • Poor response to stress and infection
    • Hypothyroidism
      • Delayed reflexes

    Tests may include:

    • Bone density test
    • Eye exams
    • MRI or CT scan

    Blood tests will be done to check levels of:

    • ACTH
    • Cholesterol
    • Cortisol
    • FSH
    • Growth hormone
    • LH
    • Prolactin
    • Somatomedin C (IGF-1)