Patient Review

  • Patient’s Name: Anonyms
  • Patient’s Age: 41
  • Patient’s Gender: male

Symptoms

  • Acute headache
  • Vomitting
  • Unable to open left eye

Case Presentation

The purpose of this case study is to highlight key clinical findings in a patient diagnosed with pituitary apoplexy. Recent advances in minimally invasive endonasal endoscopic skull base surgery have revolutionized surgery for pituitary tumors.

Visualization is significantly improved with a direct endoscopic view, and patients recover much faster with less discomfort. Typically this has reduced hospital stay to one or two days, even following complex surgery.

Dr. Sawhney specializes in performing complex brain surgeries and has successfully performed a variety of parasellar tumor resections and brain tumor surgery in Mumbai, in this fashion for more than fourteen years.

 

Dr. Gurneet Sawhney, regarded as one of the best neurosurgeon in Mumbai for performing Microneurosurgery, Neuroendoscopy, and Minimally Invasive Spine Surgeries.

The current case study describes a patient with pituitary apoplexy. It’s a rare but life-threatening condition caused by sudden hemorrhage or infarction of the pituitary gland. Pituitary apoplexy is a medical emergency and can be fatal if it is untreated or neglected. With treatment, however, the prognosis is good.

A 41-year-old man came with a complaint of sudden onset of severe headache associated with vomiting and was unable to open his left eye. MRI of the brain was done and was found to have a pituitary tumor. The condition is called pituitary macroadenoma with apoplexy.

On examination, he was found to have III new palsy because of which he was unable to open his left eyelid and also move his left eye on either side. He was optimized and taken up for Endoscopic Transnasal Transsphenoidal surgery under Neuronavigation guidance and the complete tumor was removed.

Treatment and prognosis

  • If prompt neurosurgical intervention with the transsphenoidal approach is available then prognosis is good.

Physical Examination & Tests

  • Brain MRI

Post-Operative Assessment

Postoperatively, the patient found improvement on day 1 and was able to move his eye slightly. He was discharged postoperation on Day 3. On follow-up, he was able to open his eye partially with good vision at the left eye.