DR. ROOPA ROKHADE

Abstract

Pituitary apoplexy is a life-threatening emergency caused by an acute ischemic or hemorrhagic vascular accident involving a pituitary adenoma. This condition may present with a variety of neurological and endocrinological signs and symptoms. However, isolated complete third cranial nerve palsy as the presenting sign of pituitary apoplexy is very rare. We are reporting a case of pituitary apoplexy which presented to us as acute onset unilateral, pupil involving complete third nerve palsy. MRI revealed a mass in the pituitary fossa invading the right cavernous sinus. Patient underwent neurosurgical decompression via a trans sphenoidal approach. Post-surgery, his cranial nerve palsy was completely resolved. This report highlights the importance of considering pituitary apoplexy as one of the early differential diagnoses of patients presenting with isolated third cranial nerve palsy with ptosis, apart from posterior communicating artery aneurysm.