Headache caused by pituitary apoplexy, usually with sudden (even thunderclap) onset and severe intensity, and accompanied from onset or later by visual symptoms and/or hypopituitarism.
- Any new headache fulfilling criterion C
- Acute haemorrhagic pituitary infarction has been diagnosed
- Evidence of causation demonstrated by at least two of the following:
- headache has developed in close temporal relation to other symptoms and/or clinical signs of pituitary apoplexy, or has led to the diagnosis of pituitary apoplexy
- either or both of the following:
- a) headache has significantly worsened in parallel with other symptoms and/or clinical signs of pituitary apoplexy
- b) headache has significantly improved in parallel with other symptoms and/or clinical signs of improvement of pituitary apoplexy
- headache is severe and of sudden or thunderclap onset
The rare clinical syndrome of pituitary apoplexy is an acute, life-threatening condition. It is one of the causes of non-aneurysmal subarachnoid haemorrhage.
It is also one of the causes of thunderclap headache. Most cases occur as the first presentation of rapid enlargement of non-functioning pituitary macroadenomas due to haemorrhage and/or infarction.
MRI is more sensitive than CT scan for detecting intrasellar pathology.