sudden headache

Spontaneous pituitary apoplexy in the absence of a known pre-existing pituitary adenoma is a very rare cause of sudden onset headache, but can be potentially sight- and life-threatening. We describe a case of a 37-year-old man who presented to the Emergency Department with a severe headache, associated nausea, vomiting and features of meningism. A suspected clinical diagnosis of subarachnoid haemorrhage led to an urgent computed tomography scan of the head demonstrating a large pituitary macroadenoma.