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June 1986

Intraventricular Hemorrhage From Pituitary Apoplexy

Author Affiliations

Department of Pathology Wake Forest University Bowman Gray School of Medicine Winston-Salem, NC 27103

Arch Neurol. 1986;43(6):544. doi:10.1001/archneur.1986.00520060008007

To the Editor.  —Reid et al1 have recently summarized the clinical and pathologic features of pituitary apoplexy, dividing cases of the disorder into those with and without a pituitary tumor. They pointed out that subarachnoid hemorrhage can follow bleeding within a pituitary tumor. I think another important complication of pituitary apoplexy associated with adenomas was omitted. This is the development of intraventricular hemorrhage when hemorrhage arising within a pituitary tumor ruptures through the floor of the third ventricle. In our recent case with this complication,2 the outcome was fatal. Our patient had a silent pituitary adenoma; she was undergoing chemotherapy for multiple myeloma. She presented with a sudden onset of coma and died on the same day. At the autopsy she had an endocrine-inactive pituitary adenoma that showed massive necrosis and hemorrhage. The hemorrhage had ruptured through the necrotic capsule and the floor of the third ventricle, filling

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