MIGRAINELIKE HEADACHE IN A PATIENT WITH A HEMORRHAGIC PITUITARY MACROADENOMA

A 23-year-old woman presented with a I-day history of a severe migrain elike headache with a normal neurological examination. The headache re solved after a ketorolac injection, but recurred a few hours later. An MRI scan of the brain showed a hemorrhagic pituitary macroadenoma for which she underwent transsphenoidal removal of the tumor 1 month late r. Although uncommon, pituitary hemorrhage with and without apoplexy s hould be considered in the differential diagnosis of acute headache. P ituitary hemorrhage can be routinely identified on an MRI scan even wi thout pituitary views. However, the pathology can be overlooked and un derimaged on a CT scan for acute headache using 10-mm and even 5-mm sl ices.