Cranial nerves palsy in pituitary apoplexy outcome post emergent surgery

Abstract

Introduction:pituitary apoplexy (PA), an uncommon clinical condition brought on by rapid bleeding or infarction. The primary symptom, a sudden, severe headache, is occasionally accompanied by vision abnormalities or ocular palsy. Aim of the study :to assess the benefit of an emergent trans sphenoidal approach and its results, as well as the deficit of cranial nerves other than the optic nerve in the recovery from pituitary apoplexy.Patient and methodsA prospective study of cranial nerve deficit in pituitary apoplexy and their prognosis in patients with apoplexy followed up on 16 patients from 2018 to 2020 who had cranial nerve deficits throughout their hospital stays and for up to two years following release.Results :Oculomotor nerve intracavernous segment has more predilection to involve in pituitary apoplexy cavernous invasion in our study we include other cranial nerves to expel the presenting oculomotor nerve palsy in comprise to other cranial nerves and even with mixed cranial nerve involvement, the cranial nerve involvement and cavernous extension and the volume of tumor effect additional compression on cranial nerve. Only one patient with 3rd cranial nerve palsy and one patient with mixed palsy is not recovered after six-month postoperative fellows while the majority retrieve their function during 1st three months.Conclusion:Patients with pituitary apoplexy who experienced ocular motility dysfunction due to cranial nerve palsies had favorable prognoses.Keywords: Pituitary apoplexy, cranial nerve palsy, pituitary adenoma