Abstract

Pituitary apoplexy is caused by acute infarction or haemorrhage infarctionof pre-existing pituitary adenoma or tissue adjacent. Its presentation varied from neurological impairment to various degree of endocrine dysfunction. Isolated third cranial nerve palsy as a presenting sign in pituitary apoplexy is rare. We report a case of pituitary apoplexy presenting as isolated third nerve palsy and ipsilateral visual deterioration. Brain imaging confirmed haemorrhagic pituitary tumour with upward compression onto optic chiasma and the upper part of cavernous sinus. Emergency transphenoidal decompression was performed with significant improvement of neurological signs and vision. Prompt diagnosis and intervention of such cases is crucial for patients’ recovery.

Key words: Third nerve palsy, pituitary apoplexy, transphenoidal decompression