Pituitary apoplexy manifested by sterile meningitis.

Pituitary apoplexy is rare and underdiagnosed. It results from either infarction or hemorrhage into an adenoma of the pituitary gland. The clinical presentation comprises a rapid development of impaired consciousness, severe headache, and amblyopia or diplopia. Meningeal irritation signs are considered rare and have not been reported as presenting signs. We report a 64-year-old patient whose presentation with necrosis of a pituitary adenoma was clinically indistinguishable from infectious meningitis.