Isolated abducens nerve palsy due to pituitary apoplexy after mild head trauma

Kayayurt, Kamil; Gündoğdu, Ömer Lütfi; Yavaşi, Özcan; Metin, Yavuz; Uğraş, Erhan

doi:10.1016/j.ajem.2015.07.066

Cited by 9 publications

(3 citation statements)

References 8 publications

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“…The most affected cranial nerve in PA is the oculomotor nerve followed by the trochlear nerve; however, clinical findings due to the involvement of multiple nerves can be seen [ 1 ]. In our patient, isolated abducens nerve palsy developed due to PA, which is extremely rare [ 1 , 3 , 5 , 6 ].…”

Section: Discussionmentioning

confidence: 98%

Isolated Unilateral Abducens Nerve Palsy Manifesting as a Rare Complication of Idiopathic Pituitary Apoplexy: A Case Report

Syed¹,

Mourra²,

Chatterjee³

2022

Cureus

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Pituitary apoplexy (PA) is an expansion of a pituitary adenoma due to infarction or hemorrhage of the gland. The term apoplexy usually describes larger bleeds leading to a sudden onset of symptoms. Although it is a rare condition, it can be a life-threatening emergency. PA usually presents with severe headache, nausea, vomiting, visual acuity, and field defects, frequently involving the cranial nerves directly adjacent to the pituitary gland, including third (oculomotor) cranial nerve, fourth (trochlear) cranial nerve, ophthalmic and maxillary branches of the fifth (trigeminal) cranial nerve, and, less commonly, the sixth (abducens) cranial nerve.Here, we present the case of a 36-year-old male who presented with a one-week history of worsening headache associated with double vision. On physical examination, the patient was noted to have left abducens nerve palsy. MRI brain showed anterior right T1 hyperintensity in the pituitary representing blood products. The patient was treated with analgesics and hormonal therapy with improvement in symptoms and eventual resolution of PA without the need for surgical intervention. PA is an unusual cause of acute isolated abducens nerve palsy which should be identified promptly as it is a life-threatening emergency that can be treated immediately with hormonal replacement followed by a decision to manage conservatively or surgically. The long-term follow-up includes endocrine assessment, visual assessment, and imaging surveillance.

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Section: Discussionmentioning

confidence: 98%

Isolated Unilateral Abducens Nerve Palsy Manifesting as a Rare Complication of Idiopathic Pituitary Apoplexy: A Case Report

Syed¹,

Mourra²,

Chatterjee³

2022

Cureus

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“…Also, a case report described a 68-year-old male patient who presented with an isolated abducens palsy after mild head trauma and was found to have a pituitary adenoma. The bleeding tumour expanded rapidly to compress the abducens nerve [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Isolated Sixth Cranial Nerve Palsy as Initial Presentation of Pituitary Apoplexy: A Case Report

Fadul,

Demir,

Safieh

et al. 2023

Cureus

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Pituitary apoplexy is a serious condition, which if left untreated, might lead to irreversible life-long complications. Hence, pituitary apoplexy should always be included in the differential diagnoses of a patient with an isolated sixth cranial nerve (CN) palsy. This report highlights the case of a patient presenting with isolated CN palsy associated with pituitary apoplexy. Although pituitary adenomas are common, they seldom present with isolated abducent nerve palsy without any other CN involvement. The 47-year-old female patient presented with acute right eye pain, diplopia, and a squint. Examination revealed an isolated unilateral sixth CN palsy. Brain MRI showed a sellar and suprasellar mass suggestive of hemorrhagic pituitary apoplexy. The patient was transferred to neurosurgery and underwent transsphenoidal resection of a pituitary macroadenoma. Postoperative follow-up showed clinical improvement. It is, thus, imperative for physicians to have the knowledge to recognize an isolated sixth cranial nerve palsy and its associated causes.

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“…[ 1 2 3 4 ] Pituitary apoplexy is a rare event characterized by the rapid expansion of a pituitary adenoma after a hemorrhagic event or schema and occurs in about 14%–22% of patients; age ranging from 38 to 85 with a mean age of 58.7 years. [ 5 6 ] However, the exact incidence of stroke in pituitary apoplexy is not described in the literature and is rare. [ 3 ] In the present study, both the cases were male and the ages were 40 and 38 years.…”

Section: Introductionmentioning

confidence: 99%

Pituitary apoplexy producing internal carotid and basilar artery compression: A rare case report

2018

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Pituitary apoplexy is a rare disease followed by ischemic or hemorrhagic process within the pituitary adenoma. Here, we report two cases of pituitary apoplexy with a history of sudden onset of headache, vomiting, and diminished vision. Our aim is to share our experience and discuss these cases as follows: the first one to know the compression of basilar artery along with the compression of basilar part of pons and in both the cases with compression of an internal carotid artery leading to cerebral infarcts.

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Isolated abducens nerve palsy due to pituitary apoplexy after mild head trauma

Cited by 9 publications

References 8 publications

Isolated Unilateral Abducens Nerve Palsy Manifesting as a Rare Complication of Idiopathic Pituitary Apoplexy: A Case Report

Isolated Unilateral Abducens Nerve Palsy Manifesting as a Rare Complication of Idiopathic Pituitary Apoplexy: A Case Report

Isolated Sixth Cranial Nerve Palsy as Initial Presentation of Pituitary Apoplexy: A Case Report

Pituitary apoplexy producing internal carotid and basilar artery compression: A rare case report

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