Whilst many case reports have shown late findings such as a partially or completely empty sella, very few patients with similar clinical symptoms have had early diagnosis and neuroimaging in Sheehan's syndrome. Only one report, to the best of our knowledge, pointed out the possibility of an enlarged non hemorrhagic pituitary gland in the post infarction phase of Sheehan syndrome [ 6].
With improvements of obstetric care, Sheehan's syndrome is decreasing in frequency and hypophysitis has become the most common cause of postpartum hypopituitarism. If Sheehan's syndrome used to be over diagnosed in any parous women with hypopituitarism and small glands, it may now be under diagnosed in the acute phase. The history of a delivery complicated with an episode of hypotension remains a key feature for the diagnosis.