Pituitary adenomas: possible role of bromocriptine in intratumoral hemorrhage

Magnetic resonance (MR) images of 68 patients examined for adenomas of the pituitary gland were retrospectively reviewed for the presence of hyperintensity on T1-weighted images because of recent reports suggesting that bromocriptine treatment may affect T1 values. Twenty-seven patients were examined after either surgery or radiation therapy, 29 were receiving bromocriptine, and 22 had not received any treatment at the time of MR imaging. MR imaging criteria showed evidence of subacute or chronic intratumoral hemorrhage in 18 patients, five of whom had hemorrhage proved at surgery. Ten of the 18 patients were asymptomatic from the hemorrhage; eight had headaches, visual field cuts, or cranial nerve deficits. Although an increased frequency of intratumoral hemorrhage was noted in prolactinomas and macroadenomas and in patients undergoing bromocriptine therapy, the effect of bromocriptine on bleeding was the only significant correlation (P less than .01).