Subarachnoid haemorrhage and vasospasm due to pituitary apoplexy after pituitary function tests

Pituitary apoplexy is a clinical syndrome characterized by a sudden onset o f headache, signs of meningeal irritation, visual impairment due to acute e nlargement of a pituitary adenoma caused by haemorrhage or infarction [1, 2 ]. Various factors are reported to lead to pituitary apoplexy, including br omocriptine therapy, oestrogen treatment, radiation therapy, head trauma, p regnancy, angiography, lumbar puncture, myelography and increased intracran ial pressure [1, 3]. Although the occurrence of pituitary apoplexy after a pituitary function test has been reported [4], the pathogenesis of apoplexy has not been clarified. We report a unique case of a 55-year-old man who p resented with severe headache after a combined pituitary function test, and computed tomography (CT) evidence of an infarction, with subsequent intrat umoural haemorrhage and subrachnoid haemorrhage associated with vasospasm.