Signs and symptoms of acute pituitary apoplexy include:

A. Severe headache.

B. Meningismus.

C. Vision loss.

D. Shock.

DISCUSSION: Acute pituitary apoplexy follows sudden hemorrhage into a pre-existing pituitary tumor or following closed head trauma. Symptoms, including headache, meningismus, and vision loss, are attributable to the intracerebral blood. Pituitary insufficiency, as well as the accompanying secondary adrenal insufficiency, may cause hypotension and shock. Other manifestations may include DI and myxedema. Acute pituitary apoplexy is a neurosurgical emergency that requires transsphenoidal decompression of the sella turcica.