Decompressive surgery can be necessary in the management of a macroadenoma apoplexy [ 11, 13, 24], as well as in hypophysitis [ 25] but of course never in Sheehan's syndrome where the clinical course is very predictable.
Therefore, the acute post infarction phase of Sheehan's syndrome should always be considered in the diagnosis of an enlarged non haemorrhagic pituitary gland, ruling out the need for any aggressive treatment.