title: Unusual case of bilateral caudate infarcts following pituitary apoplexy.
abstract: OBJECTIVE
  Cerebral ischemia due to pituitary apoplexy is very rare. It may be caused by vasospasm or direct compression of cerebral vessels by the expanding mass. Bilateral caudate infarcts also are very rare. To our knowledge, this is the first case report that presents pituitary apoplexy causing compression of bilateral anterior cerebral artery branches and leading to bilateral caudate infarcts.
  
  
  METHODS
  An 81-year-old woman with a pituitary macroadenoma presented with circulatory shock due to pituitary apoplexy. Neurological examination revealed new asymmetric quadriparesis with chronic bilateral visual disturbance. On brain magnetic resonance imaging, she was found to have watershed infarcts in the anterior cerebral artery-middle cerebral artery and middle cerebral artery-posterior cerebral artery watershed zones in addition to bilateral caudate infarcts.
  
  
  CONCLUSIONS
  Pituitary apoplexy can cause compression of bilateral anterior cerebral arteries from the expanding mass and lead to bilateral caudate infarcts. It is important to understand the pathophysiology of cerebral ischemia in pituitary apoplexy to improve management.
authors.affiliation: Department of Neurology, Pritzker School of Medicine, University of Chicago, Chicago, Illinois.
authors.forename: Tania
authors.initials: T
authors.lastname: Rebeiz
authors.affiliation: Department of Neurology, Pritzker School of Medicine, University of Chicago, Chicago, Illinois.
authors.forename: Wilson
authors.initials: W
authors.lastname: Cueva
authors.affiliation: Department of Neurology, Pritzker School of Medicine, University of Chicago, Chicago, Illinois.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Ardelt
mesh_terms: D000369:Aged, 80 and over; D002421:Caudate Nucleus / Q000098:blood supply / Q000473:pathology*; D002544:Cerebral Infarction / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D006801:Humans; D010899:Pituitary Apoplexy / Q000150:complications* / Q000175:diagnosis*