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Pituitary apoplexy. Pituitary apoplexy. T1W sagittal and T1W coronal images of the pituitary fossa show a pituitary mass, almost certainly a macroadenoma, which has expanded and remodelled the pituitary fossa and extended up into the suprasellar cistern where it compresses the chiasm. The macroadenoma has outgrown its blood supply and undergone haemorrhagic infarction. There is T1 hyperintense methaemoglobin diffusely within the macroadenoma. There is invasion of the right cavernous sinus (B, arrows). The patient presented with sudden-onset severe headache and visual loss. Shelley Renowden Pract Neurol 2015;15:26-41 ©2015 by BMJ Publishing Group Ltd
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