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
Challa VR. Intraventricular Hemorrhage From Pituitary Apoplexy. Arch Neurol. 1986;43(6):544. doi:10.1001/archneur.1986.00520060008007
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