{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T00:51:46Z","timestamp":1793235106984,"version":"4.5.0"},"reference-count":15,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,4,6]]},"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:p>Pituitary apoplexy (PA) is a possible complication of pituitary adenoma but is rarely followed by cerebral infarction. The mechanism by which this occurs is not totally understood but is believed to have multiple aetiologies such as arterial compression due to mass effect, vasospasm induced by the presence of blood or by vasoactive agents. In this report, we present a man in his 80s with known pituitary adenoma with a sudden onset of left central facial palsy, left hemiparesis, paresis of the VI left pair and previously unrecognised atrial fibrillation in the ECG. At first, the signs of haemorrhage on imaging were unnoticed, which led to a diagnosis of ischaemic stroke that was submitted to thrombolysis. Due to complications during hospitalisation, the team suspected of PA with panhypopituitarism, confirmed by brain MRI and blood tests. The patient underwent conservative management with glucocorticoids with resolution of the acute adrenal insufficiency related symptoms.<\/jats:p>","DOI":"10.1136\/bcr-2022-254507","type":"journal-article","created":{"date-parts":[[2023,4,25]],"date-time":"2023-04-25T11:42:21Z","timestamp":1682422941000},"page":"e254507","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Pituitary apoplexy and cerebral infarction"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3097-1823","authenticated-orcid":false,"given":"Rute","family":"Br\u00e1s-Cruz","sequence":"first","affiliation":[{"name":"Department of Medicine - Internal Medicine, Hospital Pedro Hispano, Matosinhos, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Cruz","sequence":"additional","affiliation":[{"name":"Internal Medicine, Centro Hospitalar de Vila Nova de Gaia Espinho EPE, Vila Nova de Gaia, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Cam\u00f5es","sequence":"additional","affiliation":[{"name":"Department of Medicine - Internal Medicine, Hospital Pedro Hispano, Matosinhos, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,4,25]]},"reference":[{"key":"2025082722072945000_16.4.e254507.1","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1016\/S2173-5093(11)70066-6","article-title":"Pituitary apoplexy due to macroadenoma bleeding","volume":"58","author":"Valle Feijoo","year":"2011","journal-title":"Endocrinolog\u00eda y Nutrici\u00f3n (English Edition)"},{"key":"2025082722072945000_16.4.e254507.2","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-004-0413-2"},{"key":"2025082722072945000_16.4.e254507.3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2010.03913.x"},{"key":"2025082722072945000_16.4.e254507.4","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.d1270","article-title":"Pituitary apoplexy","volume":"342","author":"Kerr","year":"2011","journal-title":"BMJ"},{"key":"2025082722072945000_16.4.e254507.5","doi-asserted-by":"publisher","DOI":"10.1210\/er.2015-1042"},{"key":"2025082722072945000_16.4.e254507.6","doi-asserted-by":"crossref","first-page":"113","DOI":"10.25259\/SNI_82_2020","article-title":"Pituitary apoplexy causing acute ischemic stroke: which treatment should be given priority","volume":"11","author":"Ahn","year":"2020","journal-title":"Surg Neurol Int"},{"key":"2025082722072945000_16.4.e254507.7","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1159\/000507190","article-title":"Pituitary apoplexy leading to cerebral infarction: a systematic review","volume":"83","author":"Jiang","year":"2020","journal-title":"Eur Neurol"},{"key":"2025082722072945000_16.4.e254507.8","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2004-0884"},{"key":"2025082722072945000_16.4.e254507.9","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.endonu.2012.01.016","article-title":"Apoplej\u00edA pituitaria. 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