DOI: https://doi.org/10.36347/sjmcr.2026.v14i11.043

Pages: 2608-2610

Pituitary apoplexy is a potentially life-threatening endocrine and neurological emergency that may reveal a previously undiagnosed pituitary adenoma. A 45-year-old woman presented with sudden severe headache of 24 hours’ duration, vomiting, and reduced visual acuity. Ophthalmological examination demonstrated bitemporal hemianopia. Hormonal assessment revealed anterior panhypopituitarism involving the corticotroph, thyrotroph, gonadotroph, and somatotroph axes, without diabetes insipidus. Magnetic resonance imaging demonstrated pituitary enlargement with intrinsic T1-hyperintense foci and peripheral enhancement surrounding non-enhancing areas, supporting pituitary apoplexy in the clinical context. The patient underwent transsphenoidal surgery and received hormone replacement for the affected endocrine axes. Histopathological examination favored a nonfunctioning pituitary adenoma. At 18 months, follow-up showed substantial ophthalmological and neurological improvement; however, panhypopituitarism persisted. This case illustrates that neuro-ophthalmological improvement following treatment may coexist with persistent endocrine dysfunction. Recognition of the presenting syndrome, assessment of cortisol deficiency, and coordinated endocrine, ophthalmological, and neurosurgical management are central to care, with continued reassessment after the acute event.