Introduction: Pituitary apoplexy is an ischemic or hemorrhagic rearrangement within a pituitary adenoma. Pituitary apoplexy is a rare disease that constitutes a diagnosis and therapeutic emergency. Most of the time, apoplexy is the manifestation inaugural of an adenoma unknown, but it can also complicate a known adenoma. All adenomas can be concerned with the occurrence of apoplexy, with an equivalent risk, whether they are secreting or not and whatever the type of secretion. We report the case of a patient in whom the cranio-encephalic MRI enabled to make the diagnosis. Observation: A 57-years-old woman abruptly presented severe cephalodynia, followed by a left visual field defect. The clinical examination revealed an alteration of the consciousness to the type of obstruction and a decrease in left visual acuity is 4/10 th . The cranio-encephalic MRI performed revealed an expansive intrasellar process with suprasellar extension of heterogeneous signal on all the sequences performed alternating hemorrhagic stigmata in the central tumor zone suggesting a macroadenoma having bled, compatible with pituitary apoplexy. She received medical treatment and hormonotherapy, followed by surgical excision. The outcome was satisfactory. Conclusion: Pituitary apoplexy is a rare but serious complication of pituitary adenomas. It is responsible for various neuro-ophthalmologic. Pituitary apoplexy involves the patient's functional and vital prognosis due to acute panhypopituitarism. It is a diagnostic and therapeutic emergency. MRI is a major contribution to diagnosis. Treatment is based on the combination of hormone replacement therapy and trans-sphenoidal tumor excision.

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Introduction: Devic's neuromyelitis optica is an autoimmune and central nervous system demyelinating disease. It mainly affects the spinal chord and optic nerves. Considered for a long time as a special form of Multiple Sclerosis (MS), it is distinguished clinically by its rarity and poor prognostic, biologically by NMO (IgG) antibody, radiologically by extended myelitis. Treatment include mega dose of methylprednisolone during relapses and immunosuppressive drug in prevention of recurrences. Observation: Devic's disease manifests itself in outbreaks of neuritis optic or myelitis. We report the case of a patient who had no particular antecedents. She presented a spastic tetraparesis, accompanied by a decreasing left visual acuity (4/10 th); the all evolving by thrust since one year. Spinal chord lesions on MRI, second stage brain damages appearance affecting the white substance and the discovery in the patient serum of anti-aquaporin 4 antibodies (anti-AQP4 Ab) allowed the diagnosis of Devic's disease. Conclusion: Diagnosis of Devic's neuromyelitis optica that was initially based on clinical examination and radiological assessment is currently confirmed by the discovery in the patient serum of the NMO immunoglobulin G directed against Aquaporin 4.