When should I consider referring a patient with suspected pituitary apoplexy to secondary care, and what information should I provide to the receiving

When to refer a patient with suspected pituitary apoplexy to secondary care: Refer urgently to secondary care if pituitary apoplexy is suspected, especially if the patient presents with acute severe headache, visual disturbances, altered consciousness, or signs of hypopituitarism such as hypotension, hyponatraemia, or hypoglycaemia. Early specialist assessment is critical due to the potential for rapid deterioration and the need for urgent imaging and endocrine management.

Information to provide to the receiving team: Provide a detailed clinical history including the onset and nature of symptoms (e.g., sudden severe headache, visual changes, neurological deficits), vital signs, Glasgow Coma Scale score if applicable, any signs of hormonal deficiency (e.g., fatigue, hypotension, electrolyte abnormalities), results of any initial investigations (such as blood tests indicating hyponatraemia or hypoglycaemia), and any treatments already administered (e.g., steroids or supportive care). Also include any relevant past medical history, medications, and the timeline of symptom progression.