Pituitary apoplexy associated with cardiac surgery

Two cases of pituitary apoplexy were detected in the immediate postoperative period after cardiac surgery with extracorporeal bypass. Both patients had pituitary adenomas that were asymptomatic and previously undiagnosed. One patient, a 57-year-old man, had unilateral total ophthalmoplegia and blepharoptosis with sparing of the visual system. The second patient, a 55-year-old man, had headache, marked bilateral visual loss, and ophthalmoplegia with subsequent development of a hemiparesis. Pituitary apoplexy was confirmed pathologically in both cases. Hemodynamic instability during and immediately after surgery and anticoagulation are probable precipitating factors.