Alyami Hadi S, Al Wadany Muhannad M, Almousa Abdulelah S, Khawaji Ethar A, Almousa Abdulrahman M, Albaqshi Mohammed A, Alharbi Ahlam S
General Practice, King Faisal University, Hofuf, SAU.
General Practice, Jazan University, Jazan, SAU.
Cureus. 2022 Dec 22;14(12):e32810. doi: 10.7759/cureus.32810. eCollection 2022 Dec.
Pituitary apoplexy is a rare and potentially life-threatening condition that usually occurs in the setting of a pre-existing pituitary tumor, which may be undiagnosed. There are a growing number of reports describing the pituitary apoplexy associated with coronavirus disease 2019 (COVID-19). We present the case of a 41-year-old man who presented with a gradually worsening headache for four days. It was a bilateral frontal headache of sharp quality with no radiation. He scored the headache as 9 out of 10 on the 10-point severity scale. He had no previous episodes of similar headaches. Fundoscopic examination revealed bilateral optic disc blurring suggestive of papilledema and cranial nerves examination revealed bilateral hemianopia. The patient was admitted for further investigation and management. As part of the admission protocol, the patent underwent a nasopharyngeal swab for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which yielded positive results. Computed tomography demonstrated a large solid intrasellar mass with areas of high density suggesting hemorrhage along with a small amount of subarachnoid hemorrhage space in the left parietal lobe. The findings were consistent with pituitary apoplexy in the setting of pituitary macroadenoma. Intravenous hydrocortisone was administered. The patient underwent transsphenoidal surgical resection of the pituitary tumor, which resulted in significant improvement in the patient's symptoms. Pituitary apoplexy is a rare condition. The case suggests that COVID-19 may predispose to the development of pituitary apoplexy.
垂体卒中是一种罕见且可能危及生命的疾病，通常发生在已存在的垂体肿瘤背景下，而该肿瘤可能尚未被诊断出来。越来越多的报告描述了与2019冠状病毒病（COVID-19）相关的垂体卒中。我们报告一例41岁男性患者，其出现逐渐加重的头痛4天。头痛为双侧额部锐痛，无放射痛。他在10分制的严重程度量表上对头痛的评分是9分。他既往无类似头痛发作史。眼底检查显示双侧视盘模糊，提示视乳头水肿，脑神经检查显示双侧偏盲。患者入院进一步检查和治疗。作为入院流程的一部分，患者接受了严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的鼻咽拭子检测，结果呈阳性。计算机断层扫描显示鞍内有一个大的实性肿块，高密度区域提示出血，同时左顶叶有少量蛛网膜下腔出血。这些发现与垂体大腺瘤背景下的垂体卒中一致。给予静脉注射氢化可的松。患者接受了垂体肿瘤的经蝶窦手术切除，症状得到显著改善。垂体卒中是一种罕见疾病。该病例提示COVID-19可能易引发垂体卒中。
