Pituitary apoplexy in a patient on antiplatelet therapy: A case report

Pituitary apoplexy is a rare but life-threatening neurosurgical emergency, typically caused by acute hemorrhage or infarction of a pituitary adenoma within the sella turcica. It presents clinically with the sudden onset of severe headache, visual impairment and ophthalmoplegia. The present study reported the case of a 45-year-old male who experienced intermittent headaches and progressive right-sided visual deterioration over two months, with acute worsening in the preceding 6 h. The patient's medical history included coronary stent implantation and the patient had been on enteric-coated aspirin therapy for ~4 months. Magnetic resonance imaging and computed tomography of the head confirmed the diagnosis of pituitary apoplexy. The patient underwent emergency endoscopic transsphenoidal surgery, leading to significant improvement in right-sided vision. At the 6-month follow-up, the patient exhibited complete recovery with no evidence of tumor recurrence on imaging. This case highlights the importance of timely diagnosis and surgical intervention in achieving favorable outcomes in pituitary apoplexy and serves as a reminder for clinicians to consider the risk of hemorrhage in patients on long-term antiplatelet therapy.