Left anterior and Middle cerebral artery stroke associated with Pituitary apoplexy in an adolescent male with Giant prolactinoma: A Case Report

Background: Pituitary apoplexy is a life-threatening condition in which there is a hemorrhage or infarction of the pituitary gland. It can be characterized by the sudden onset of headaches, vomiting, visual impairment, endocrine deficits, and changes in consciousness. There are very few cases of pituitary apoplexy presenting as strokes in children. We report a rare occurrence of an ischemic stroke in the left anterior and middle cerebral artery territories, caused by pituitary apoplexy from a prolactinoma in a 13-year-old male which was managed medically. Case Presentation: He presented with worsening headaches and visual acuity and later developed left oculomotor nerve palsy, right hemiplegia, and dysarthria. MRI and CT imaging confirmed an apoplectic pituitary macroadenoma with internal carotid artery encasement and infarction in the territory of the left middle and anterior cerebral arteries. The patient was treated using dopamine agonists, which led to a decrease in tumor size and serum prolactin levels without surgery. Conclusion: This report emphasizes the need to promptly recognize pituitary apoplexy as a potential cause of stroke in children. It also illustrates successful medical management in these cases, which could be especially important in areas with limited resources