Pituitary Adenoma With Apoplexy Presenting As Unilateral Third Nerve Palsy

Pituitary adenomas are one of the most common intracranial tumors. Non-functioning macroadenomas usually diagnosed when they cause symptoms due to mass effect on surrounding structures. We present case a 48-year-old man who presented with headache associated ptosis right eye and right-sided blurry vision for three days. Initial computerized tomography (CT) scan head did not report mass, acute infarct, or hemorrhage. He was given 325mg aspirin concern stroke while waiting magnetic resonance imaging (MRI) brain, which done next day revealed pituitary macroadenoma hemorrhage, effect, compression optic chiasm consistent apoplexy. ultimately underwent trans-sphenoidal resection tumor; however, his surgery delayed five days as he had received high dose in Emergency Room. His adrenocorticotropic hormone (ACTH), cortisol, testosterone levels were found be quite low. administered stress steroids peri-operatively discharged indefinite hydrocortisone therapy endocrinology follow-up. Our highlights serious complication that can occur called apoplexy is caused by ischemic infarction hemorrhage pituitary. It needs prompt identification management. also emphasizes importance recognizing causes sudden onset cranial nerve deficits, it rare presentation taken Department.