Glaucoma pituitary apoplexy is typically heralded by the onset of severe headaches along with a variable combination of impaired vision, ophthalmoplegia, and endocrinologic dysfunction.1 We describe a patient who developed angle closure glaucoma presumably precipitated by mydriasis accompanying apoplexy-induced oculomotor palsy.
Report of a Case.
—A 47-year-old woman developed sudden severe headaches followed 3 hours later by diplopia. Examination revealed visual acuities of 20/200 in the right eye and counting fingers in the left eye. There were complete palsies of the left cranial nerves III, IV, and VI. Magnetic resonance imaging revealed a large mass within an expanded left hemisella, with erosion into the left sphenoid sinus and cavernous sinus (Figure). A presumptive diagnosis of pituitary apoplexy was made. Following transsphenoidal resection of the mass, the results of pathologic examination showed a necrotic, corticotropin-producing pituitary adenoma.On the first postoperative day, a complete left ophthalmoplegia was again noted. The
Goldey SH, Hamed LM, Sherwood MB, Phillips PH. Pituitary Apoplexy Precipitating Acute Angle Closure. Arch Ophthalmol. 1992;110(12):1687-1688. doi:10.1001/archopht.1992.01080240025017