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This report describes the clinical course of pituitary apoplexy induced by a single dose of bromocriptine in a 50-year-old woman with acromegaly. The patient suddenly complained of diminished vision and headache 2 hours after the oral administration of 2.5 mg of bromocriptine. Her visual symptoms and headache persisted for several days. The basal plasma GH concentration decreased from 76.2 ng/ml to 37.2 ng/ml the day after the attack of apoplexy and to 3.0 ng/ml on the 9th day. The authors assess the changes in endocrine findings related to pituitary apoplexy and also emphasize the necessity to view with caution any symptomatic change during bromocriptine therapy.

Three cases of intraspinal tumors associated with hydrocephalus were encountered and treated. This review includes 67 cases, including these 3 cases, and discusses the pitfalls associated with intraspinal tumors presenting with hydrocephalus. These tumors are not easily diagnosed, especially in cases where the chief complaint, due to hydrocephalus, is headache or dementia, and does not include back pain. Among the 67 cases reviewed, symptoms suggesting normal pressure hydrocephalus were particularly noticed in patients over 40 years old. In cases presenting with headaches or dementia, back pain corresponding to the tumor location may appear after a shunt operation or external ventricular drainage. This postoperative back pain is important in indicating the presence of an intraspinal tumor.