Pituitary apoplexy: diagnosis by computed tomography.

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Abstract
Pituitary apoplexy, the sudden enlargement of a pituitary adenoma, is difficult to diagnose. Sudden infarction, necrosis or hemorrhage into a pituitary adenoma may be threatening to both vision and life if not treated promptly. Computed tomography (CT) now enables the early diagnosis of pituitary apoplexy. Since CT can detect blood, it can document acute or chronic hemorrhage in pituitary adenomas. CT can discriminate between densities other than blood and can therefore be used to diagnose those cases of pituitary apoplexy in which infarction and necrosis predominate. These conclusions were verified by a review of 10 apoplectic patients studied by CT. Although 9 diagnostic delays occurred, tissue confirmation by surgery in 8 cases and autopsy on 1 revealed CT findings which should be useful in future diagnosis.