Pituitary infarction

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Endocrine glands

Pituitary apoplexy

Symptoms usually include severe headache, ophthalmoplegia (paralysis of the eye muscles causing double vision), and symptoms of acute adrenal insufficiency (low blood pressure, nausea, and vomiting).

Less commonly, pituitary dysfunction may appear more slowly. In Sheehan syndrome, for example, the first symptom may be a failure to produce milk caused by a lack of the hormone prolactin.

Over time, problems with other pituitary hormones may develop, causing symptoms of the following conditions:

• Hypogonadism
  • Amenorrhea in women
  • Sexual dysfunction and loss of muscle mass in men
• Hypothyroidism
  • Dry skin
  • Mental slowing
  • Weight gain
  • Cold intolerance
  • Hoarseness
• Hypoadrenalism (if not already present or treated)
  • Low blood pressure
  • Nausea
  • Inability to deal with physical stress
• Growth hormone deficiency
  • Fatigue
  • Lack of energy
  • Loss of bone and muscle
  • Increased abdominal fat
  • Dyslipidemia (problems with fat metabolism)

When the posterior pituitary is involved (rare), there may be uncontrolled urination. In women, this can cause failure of the uterus to contract as needed to give birth to a baby and failure to produce breast milk.

Signs of acute infarction may include ophthalmoplegia, visual field defects, and hypotension (low blood pressure).

Signs of chronic pituitary insufficiency include:

• Hypogonadism
  • Sparse axillary and pubic hair
  • Loss of sexual function
  • Cessation of menstrual cycle in women
  • Erectile dysfunction in men
  • Bone fractures
• Hypothyroidism
  • Dry hair and skin
  • Puffy face
  • Delayed reflexes
• Hypoadrenalism
  • Hypotension
  • Poor response to stress and infection
• Hypoprolactinemia -- lack of lactation
• Growth hormone deficiency -- obesity and loss of muscle mass
• General -- fine, pale, wrinkled skin

Tests may include:

• Eye exams
• MRI or CT scan showing hemorrhage
• Bone density test (shows low bone mineral density)

Blood tests will be done to check levels of FSH, LH, cortisol, ACTH, growth hormone, somatomedin C (IGF-1), prolactin, and cholesterol.

Review Date: 08/11/2006
Reviewed By: Robert Hurd, MD, Department of Biology, College of Arts and Sciences, Xavier University, Cincinnati, OH. Review provided by VeriMed Healthcare Network.