The second manner of presentation relates to increasing size of the tumor. These are usually tumors that do not cause hormone secretion. These tumors can get to be rather large and cause visual problems. The most common is the loss of peripheral vision. This can progress to blindness if not treated.
Large tumors can also cause blockage of spinal fluid, which can result in hydrocephalus .
Additionally, large tumors can compress the normal pituitary gland and cause a lack of hormones. Finally, there is something called pituitary apoplexy . This is a sudden onset of headache, visual loss, double vision and sometimes drowsiness that is caused by infarction or hemorrhage of the tumor. This last problem can become an emergency depending on its severity. As always, the first steps in diagnosis area careful history and physical examination.