Pituitary apoplexy Quiz: Ace Your Exams

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A 38-year-old woman comes to the emergency department because of a severe headache and multiple episodes of non-bloody, non-bilious emesis for the past few hours. Review of systems is significant for fatigue, constipation, and problems with peripheral field vision for the past few months. Her last menstrual period was 4 months ago. Temperature is 37.0°C (98.6°F), pulse is 58/min, respirations are 10/min, and blood pressure is 92/64 mm Hg. Physical examination shows a lethargic female complaining of severe pain. Visual field is tunneled with doubling of vision. Head magnetic resonance imaging is shown below:


Reproduced from: Wikimedia Commons

Which of the following is the most likely diagnosis?

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