Case ReportPituitary apoplexy presenting as an intraventricular hemorrhage: An infrequent neurovascular emergency

- Pituitary macroadenomas may debut with a pituitary apoplexy.
- Pituitary apoplexy hemorrhage can be mistaken for an aneurysmal rupture, especially if it extends into the ventricles.
- Hemorrhage within the pituitary tumor may be the result of disproportionate growth in relation to blood flow.

Pituitary macroadenomas may present with a pituitary apoplexy, commonly with associated hemorrhage, but rarely large enough to show an intraventricular bleeding. This is a case report of a 66-year-old woman with a 3-month history of headache, hyporexia, asthenia and altered consciousness. First evaluations showed a large intraventricular hemorrhage on CT scan that was initially misdiagnosed for an aneurysmal rupture etiology but later confirmed to be a pituitary apoplexy from a large pituitary adenoma. Intraventricular hemorrhage due to a pituitary apoplexy could be mistaken for an aneurysmal origin thus warranting for a careful evaluation of the sellar region.