{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:31:57Z","timestamp":1786649517161,"version":"build-2736575974"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:p>Pituitary apoplexy, defined by an acute ischemic or hemorrhagic event of the pituitary gland, can lead to neurological deficits. We present the case of a 43-year-old male who initially exhibited symptoms resembling trigeminal autonomic cephalalgia (TAC) as sudden-onset headache, ptosis, and autonomic symptoms. He later developed abducens nerve palsy and magnetic resonance imaging revealed a pituitary macroadenoma with intratumoral hemorrhage. Endocrine evaluation showed multiple hormonal deficiencies. The patient was diagnosed with pituitary apoplexy and referred for surgical intervention. This case highlights the importance of considering pituitary apoplexy in the differential diagnosis of TAC-like presentations and emphasizes the importance of neuroimaging in patients presenting atypical headaches. Early recognition and appropriate management are crucial for optimizing outcomes in this potentially life-threatening condition.<\/jats:p>","DOI":"10.4103\/ant.ant-d-24-00033","type":"journal-article","created":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T21:00:09Z","timestamp":1777150809000},"page":"96-98","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Pituitary Apoplexy with the Initial Presentations Similar to Trigeminal Autonomic Cephalalgia: A Case Report"],"prefix":"10.4103","volume":"35","author":[{"given":"Chien-Ya","family":"Hsu","sequence":"first","affiliation":[{"name":"Department of Neurology, Chang Gung Memorial Hospital Linkou Medical Center and Chang Gung University College of Medicine, Taoyuan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Hong","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurology, Chang Gung Memorial Hospital Linkou Medical Center and Chang Gung University College of Medicine, Taoyuan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"key":"R1-20260427","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1093\/brain\/awn010","article-title":"Paroxysmal hemicrania: A prospective clinical study of 31 cases","volume":"131","author":"Cittadini","year":"2008","journal-title":"Brain"},{"key":"R2-20260427","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1046\/j.1526-4610.2002.02171.x","article-title":"Refining the clinical spectrum of chronic paroxysmal hemicrania: A review of 74 patients","volume":"42","author":"Boes","year":"2002","journal-title":"Headache"},{"key":"R3-20260427","first-page":"1","article-title":"The International Classification of Headache Disorders, 3rd edition","volume":"38","year":"2018","journal-title":"Cephalalgia"},{"key":"R4-20260427","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1111\/cen.12314","article-title":"Headache and pituitary disease: A systematic review","volume":"79","author":"Kreitschmann-Andermahr","year":"2013","journal-title":"Clin Endocrinol (Oxf)"},{"key":"R5-20260427","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1186\/s10194-016-0614-0","article-title":"Chronic cluster headache and the pituitary gland","volume":"17","author":"De Pue","year":"2016","journal-title":"J Headache Pain"},{"key":"R6-20260427","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1212\/WNL.0000000000006697","article-title":"Red and orange flags for secondary headaches in clinical practice: SNNOOP10 list","volume":"92","author":"Do","year":"2019","journal-title":"Neurology"},{"key":"R7-20260427","doi-asserted-by":"crossref","first-page":"3294","DOI":"10.12998\/wjcc.v9.i14.3294","article-title":"Cluster headache due to structural lesions: A systematic review of published cases","volume":"9","author":"Long","year":"2021","journal-title":"World J Clin Cases"},{"key":"R8-20260427","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1210\/er.2015-1042","article-title":"Pituitary apoplexy","volume":"36","author":"Briet","year":"2015","journal-title":"Endocr Rev"},{"key":"R9-20260427","doi-asserted-by":"crossref","first-page":"R179","DOI":"10.1530\/EJE-14-0794","article-title":"Management of endocrine disease: Pituitary tumour apoplexy","volume":"172","author":"Capatina","year":"2015","journal-title":"Eur J Endocrinol"},{"key":"R10-20260427","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1111\/j.1365-2265.2010.03913.x","article-title":"UK guidelines for the management of pituitary apoplexy","volume":"74","author":"Rajasekaran","year":"2011","journal-title":"Clin Endocrinol (Oxf)"},{"key":"R11-20260427","doi-asserted-by":"crossref","first-page":"1874","DOI":"10.1001\/jama.2021.1640","article-title":"Diagnosis and management of headache: A review","volume":"325","author":"Robbins","year":"2021","journal-title":"JAMA"},{"key":"R12-20260427","doi-asserted-by":"crossref","first-page":"15330338211043032","DOI":"10.1177\/15330338211043032","article-title":"Endoscopic endonasal transsphenoidal approach for the surgical treatment of pituitary apoplexy and clinical outcomes","volume":"20","author":"Sun","year":"2021","journal-title":"Technol Cancer Res Treat"}],"container-title":["Acta Neurologica Taiwanica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ant.ANT-D-24-00033","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:54:57Z","timestamp":1786647297000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ant.ANT-D-24-00033"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":12,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/ant.ant-d-24-00033","relation":{},"ISSN":["1028-768X","3050-9173"],"issn-type":[{"value":"1028-768X","type":"print"},{"value":"3050-9173","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"2024-09-18","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-27","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}