Sheehan syndrome: a splinter of the mind.
A 40-year-old woman presented with headache and diplopia after hypotension from postpartum hemorrhage. A noncontrasted cranial magnetic resonance imaging (MRI) showed an enlarged pituitary with a rim of slight increased signal. A repeat gadolinium-enhanced cranial MRI showed peripheral enhancement of the pituitary gland surrounding an isointense central area consistent with infarction of the pituitary and the clinical diagnosis of Sheehan syndrome. The patient was treated with intravenous hydrocortisone. Immediately after treatment, her symptoms remitted and the examination normalized. One month later, a gadolinium-enhanced cranial MRI was normal. The characteristic appearance of the post-gadolinium enhanced cranial MRI helped confirm the diagnosis of Sheehan syndrome and facilitate early treatment with corticosteroids.
Vaphiades
Michael S
MS
Department of Ophthalmology, University of Alabama-Birmingham, Suite 601, 700 South 18th Street, Birmingham, AL 35233, USA.
Simmons
Debra
D
Archer
Robert L
RL
Stringer
Warren
W
D000328:Adult; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D007018:Hypopituitarism / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D007022:Hypotension / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D007262:Infusions, Intravenous; D008279:Magnetic Resonance Imaging; D009336:Necrosis; D010903:Pituitary Gland, Anterior / Q000473:pathology*; D006473:Postpartum Hemorrhage / Q000150:complications* / Q000188:drug therapy; D011247:Pregnancy; D016896:Treatment Outcome
D005938:Glucocorticoids; D006854:Hydrocortisone