Hemorrhage within pituitary adenomas: How often associated with pituitary apoplexy syndrome?

S. G. Ostrov, R. M. Quencer, J. C. Hoffman, P. C. Davis, A. N. Hasso, N. J. David

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


To determine the clinical significance and specificity of suspected intratumoral hemorrhage in pituitary adenomas, we reviewed the clinical presentations, CT results, and findings at surgery in 12 patients who had hyperintense signal within intrasellar and suprasellar masses on short TR/TE spin-echo MR pulse sequences. Eight of the cases were confirmed at surgery. In seven of the operated cases, hemorrhage was found within pituitary adenomas and in the eighth case there was hemorrhage but no identifiable adenomatous tissue. Nine of the 12 patients had CT scans; three had focal areas of increased attenuation, four had focal areas of decreased attenuation, and two had uniform hypoattenuation. All nine of these CT abnormalities correlated with areas of hemorrhage on MR. Three patients had clinical apoplexy; in two there was increased attenuation on CT and in one it was decreased. We found that intratumoral hemorrhage may be seen without clinical evidence of pituitary apoplexy, and that the areas of hemorrhage can appear as low attenuation on CT. CT may be better for visualizing intratumoral hemorrhage within the first few days, but MR is more sensitive in detecting and following the hemorrhage in the subacute stage.

Original languageEnglish (US)
Pages (from-to)503-510
Number of pages8
JournalAmerican Journal of Neuroradiology
Issue number3
StatePublished - Jan 1 1989

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology


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