A 13 year old boy presented with acute onset of sudden severe headache and visual impairment following a one-year history of intermittent frontal headache. Serum prolactin level was 17532ng/ml (normal 3–24ng/ml). Magnetic resonance imaging showed a large intrasellar mass with suprasellar extension and evidence of recent hemorrhage within the mass. Cabergoline was started and laparoscopic trans sphenoidal resection of pituitary adenoma was performed. Six months post therapy, he had complete restoration of right eye vision, and partial restoration of left one. Early surgical intervention in addition to medical therapy in case of pediatric pituitary apoplexy associated with giant prolactinoma might be essential to restore vision.
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