Meningitis as the presenting symptom of pituitary adenomata.

THE common presentation of pituitary tumours is with the gradual onset of visual impairment, often in patients in whom there is evidence of endocrine abnormality. Infarction or haemorrhage of a pituitary tumour which has hitherto been clinically silent can result in the dramatic syndrome known as pituitary apoplexy. The onset is characterized by severe headache, vomiting, pyrexia, drowsiness leading sometimes to coma and associated with ophthalmoplegia and sudden blindness.