Endocrine Abstracts

JOINT1893

Introduction: Pituitary tumors more specifically prolactinomas, causing elevated serum prolactin, can lead to symptoms like galactorrhea, menstrual irregularities, and neurological issues, sometimes increasing the risk of stroke. This case demonstrates a patient with elevated prolactin levels and stroke mimics (non-vascular conditions that present with symptoms similar to stroke.)

Case report: A 62-year-old male has been hospitalized for dizziness, loss of coordination, motor aphasia, right-sided weakness and numbness in the face. The healthcare professionals diagnosed acute stroke: determined patient eligibility for Intravenous thrombolysis, included a contrast-enhanced CT angiography (CTA), which showed no signs of ischemic or hemorrhagic stroke and alteplase was administered intravenously. The patient’s neurological impairment has not improved. An MRI of the brain revealed only a 1.6 cm hypophysial incidentaloma, prompting further investigation of prolactin levels. The patient’s prolactin level was found to be 18 times above the normal range. Based on these findings, a diagnosis of prolactinoma was made. The patient was started on cabergoline therapy (0.5 mg twice weekly), which resulted in a complete resolution of his neurological symptoms within several months. After initiation of treatment prolactin level normalized.

Conclusions: This case highlights the importance of considering prolactinomas in the list of stroke mimics. This case demonstrates that elevated prolactin levels can cause neurological manifestations independently. Although prolactinomas can be a risk factor for stroke.