South African Journal of Radiology · Published 2026-07-13 · DOI 10.4102/sajr.v30i1.3479
Tavonga P.C.S. Bayela, Suzanne O'Hagan, Christelle Ackermann
Concurrent pituitary apoplexy and ruptured intracranial aneurysm are rare, but potentially fatal, if unrecognised. A 53-year-old hypertensive woman presented with acute confusion and transient hemiparesis. Brain CT demonstrated a haemorrhagic sellar–suprasellar mass with atypical subarachnoid and intraventricular haemorrhage. CT angiography (CTA) confirmed a ruptured right middle cerebral artery (MCA) aneurysm and two additional unruptured aneurysms. Subsequent endovascular coil embolisation was successful. The pituitary macroadenoma was managed conservatively. Contribution: Early recognition using haemorrhage pattern analysis and CTA is critical to avoid missed dual pathology in pituitary apoplexy and to guide timely management.
Abstract from DOAJ. Public domain (CC0 1.0).
Read the article at the publisher →
Bayela, T., O'Hagan, S., Ackermann, C. (2026). When two bleeds collide: Pituitary apoplexy masking a ruptured intracranial aneurysm. South African Journal of Radiology. https://doi.org/10.4102/sajr.v30i1.3479