Pituitary Apoplexy Presenting With Oculomotor Nerve Palsy and Headache as the Initial Symptoms: A Case Report

ABSTRACT Pituitary apoplexy is a rare clinical syndrome. This report presents a case with initial symptoms of oculomotor nerve palsy and headache. A 48‐year‐old patient reported blurred vision in the right eye for 1 month, followed by a sudden onset of left eyelid ptosis and a 1‐day headache. Labora...

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Main Authors: Qifan Hou, Lixin Xu, Jing Yi
Format: Article
Language:English
Published: Wiley 2025-02-01
Series:Clinical Case Reports
Subjects:
Online Access:https://doi.org/10.1002/ccr3.70178
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author Qifan Hou
Lixin Xu
Jing Yi
author_facet Qifan Hou
Lixin Xu
Jing Yi
author_sort Qifan Hou
collection DOAJ
description ABSTRACT Pituitary apoplexy is a rare clinical syndrome. This report presents a case with initial symptoms of oculomotor nerve palsy and headache. A 48‐year‐old patient reported blurred vision in the right eye for 1 month, followed by a sudden onset of left eyelid ptosis and a 1‐day headache. Laboratory tests revealed normal pituitary function, except for an elevated growth hormone level (> 36.600 μg/L). Preoperative computed tomography (CT) and magnetic resonance imaging (MRI) scans indicated space‐occupying lesion in the sellar region. The lesion was subsequently resected via transnasal subtotal surgery. Histopathological and immunohistochemical analyses confirmed a pituitary adenoma with infarction. The patient received hydrocortisone preoperatively and prednisone and levothyroxine postoperatively. On the second postoperative day, the headache resolved, and the left eyelid regained normal function within 2 weeks. Pituitary apoplexy is extremely rare, with initial presentations of oculomotor nerve palsy being exceptionally uncommon. Early diagnosis and prompt surgical intervention are essential to preserve pituitary function and rapidly alleviate cranial nerve dysfunction.
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spelling doaj-art-5ac2e59e376342aeb6cda645a4fb96372025-08-20T02:15:51ZengWileyClinical Case Reports2050-09042025-02-01132n/an/a10.1002/ccr3.70178Pituitary Apoplexy Presenting With Oculomotor Nerve Palsy and Headache as the Initial Symptoms: A Case ReportQifan Hou0Lixin Xu1Jing Yi2Department of Neurosurgery, Changde Hospital, Xiangya School of Medicine Central South University (The First People's Hospital of Changde City) Changde Hunan ChinaDepartment of Neurosurgery, Changde Hospital, Xiangya School of Medicine Central South University (The First People's Hospital of Changde City) Changde Hunan ChinaDepartment of Neurosurgery, Changde Hospital, Xiangya School of Medicine Central South University (The First People's Hospital of Changde City) Changde Hunan ChinaABSTRACT Pituitary apoplexy is a rare clinical syndrome. This report presents a case with initial symptoms of oculomotor nerve palsy and headache. A 48‐year‐old patient reported blurred vision in the right eye for 1 month, followed by a sudden onset of left eyelid ptosis and a 1‐day headache. Laboratory tests revealed normal pituitary function, except for an elevated growth hormone level (> 36.600 μg/L). Preoperative computed tomography (CT) and magnetic resonance imaging (MRI) scans indicated space‐occupying lesion in the sellar region. The lesion was subsequently resected via transnasal subtotal surgery. Histopathological and immunohistochemical analyses confirmed a pituitary adenoma with infarction. The patient received hydrocortisone preoperatively and prednisone and levothyroxine postoperatively. On the second postoperative day, the headache resolved, and the left eyelid regained normal function within 2 weeks. Pituitary apoplexy is extremely rare, with initial presentations of oculomotor nerve palsy being exceptionally uncommon. Early diagnosis and prompt surgical intervention are essential to preserve pituitary function and rapidly alleviate cranial nerve dysfunction.https://doi.org/10.1002/ccr3.70178case reportheadacheoculomotor nerve palsypituitary apoplexy
spellingShingle Qifan Hou
Lixin Xu
Jing Yi
Pituitary Apoplexy Presenting With Oculomotor Nerve Palsy and Headache as the Initial Symptoms: A Case Report
Clinical Case Reports
case report
headache
oculomotor nerve palsy
pituitary apoplexy
title Pituitary Apoplexy Presenting With Oculomotor Nerve Palsy and Headache as the Initial Symptoms: A Case Report
title_full Pituitary Apoplexy Presenting With Oculomotor Nerve Palsy and Headache as the Initial Symptoms: A Case Report
title_fullStr Pituitary Apoplexy Presenting With Oculomotor Nerve Palsy and Headache as the Initial Symptoms: A Case Report
title_full_unstemmed Pituitary Apoplexy Presenting With Oculomotor Nerve Palsy and Headache as the Initial Symptoms: A Case Report
title_short Pituitary Apoplexy Presenting With Oculomotor Nerve Palsy and Headache as the Initial Symptoms: A Case Report
title_sort pituitary apoplexy presenting with oculomotor nerve palsy and headache as the initial symptoms a case report
topic case report
headache
oculomotor nerve palsy
pituitary apoplexy
url https://doi.org/10.1002/ccr3.70178
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AT lixinxu pituitaryapoplexypresentingwithoculomotornervepalsyandheadacheastheinitialsymptomsacasereport
AT jingyi pituitaryapoplexypresentingwithoculomotornervepalsyandheadacheastheinitialsymptomsacasereport