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Updated: Jul 14, 2026

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
07:43

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

Published on: January 17, 2018

An interesting case of a pituitary adenoma apoplexy mimicking an acute meningitis. Case report

S Chibbaro1, L Benvenuti, S Carnesecchi

  • 1Division of Neurosurgery, Spedali Riuniti, Livorno, Italy. schibbaro@hotmail.com

Journal of Neurosurgical Sciences
|June 16, 2007
PubMed

Insights

Pituitary apoplexy, a rare condition involving bleeding or infarction of a pituitary adenoma, can mimic meningitis. Surgical intervention is recommended to prevent vision loss and recurrence.

Area of Science:

  • Neuroendocrinology
  • Neurosurgery

Background:

  • Pituitary apoplexy is a rare clinical event resulting from infarction or hemorrhage within a pituitary adenoma.
  • It typically presents with sudden headache, visual impairment, and oculomotor nerve palsy, but meningeal signs are uncommon.

Observation:

  • A 33-year-old male presented with pituitary macroadenoma apoplexy, initially mimicking infectious meningitis.
  • The patient developed temporary left third nerve palsy post-surgery, which resolved within two months.

Findings:

  • Surgical management via right pterional craniotomy achieved complete tumor removal.
  • The case highlights the diagnostic challenge of pituitary apoplexy, especially when presenting with meningeal signs.

Implications:

  • Surgical intervention for pituitary apoplexy is advocated over conservative management to prevent visual deficits and recurrence.
  • Early surgical decompression is crucial for preserving pituitary function and preventing long-term complications.

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