Pituitary macroadenomas with oculomotor cistern extension and tracking: implications for surgical management

• DOI: 10.3171/2015.5.jns15107
• Publication Date: 2015-11-13T14:59:49Z
• Authors: Nguyen Hoang; Diem Kieu Tran; Ryan Herde; Genevieve C. Coul...; Anne G. Osborn; William T. Couldwell
• Keywords: Oculomotor nerve palsy; Oculomotor nerve; Cistern; Pituitary apoplexy

OBJECT Oculomotor cistern extension of pituitary adenomas is an overlooked feature within the literature. In this study, 7 cases macroadenoma with oculomotor and tracking are highlighted, implications surgical medical management discussed. METHODS The records patients diagnosed macroadenomas who underwent resection in whom preoperative protocol MRI scans were available for review retrospectively reviewed. patient tumor characteristics reviewed along operative outcomes complications. RESULTS Seven (4.1%) identified a cohort 170 macroadenoma. most common presenting symptoms visual deficit (6 patients; 86%), apoplexy (3 43%), nerve palsy 43%). Lone was seen 2 without 1 apoplectic event. Gross-total achieved via microscopic endonasal transsphenoidal approach or endoscopic aid to sella 14%, near-total 29%, subtotal 57% data set. CONCLUSIONS Pituitary adenoma uncommon; however, preoperatively recognizing such should play important role surgeon's considerations postoperative clinical because can limit gross-total using alone.