Abstract：
PURPOSE:Oculomotor nerve palsy (ONP) occasionally occurs in cases of pituitary apoplexy (PA) associated with pituitary adenoma, but its mechanism remains unclear. Intracranial nerves are clearly visualized by fast-imaging employing with steady-state acquisition (FIESTA). Here, we assessed the oculomotor nerve compression in patients with PA associated with pituitary adenoma using FIESTA. METHODS:Twenty-eight cases of PA, with or without ONP, were retrospectively reviewed. All patients had undergone preoperative FIESTA. Two neuroradiologists, unaware of the patient's clinical symptoms, evaluated the presence and location of oculomotor nerve compression due to the tumor. RESULTS:Thirteen of the twenty-eight PA cases were associated with ONP. Tumor size and degree of cavernous sinus invasion were not significantly different between the ONP and non-ONP groups. Even in the ONP group, 8/13 (62%) tumors did not show cavernous sinus invasion. Via FIESTA, the presence of oculomotor nerve compression was confirmed in 11/13 (85%) and 5/15 (33%) cases in the ONP and non-ONP groups, respectively (p = 0.008). The radiologists' diagnoses of laterality of nerve compression (right or left) were consistent with the patient's affected eye. In the ONP group, the location of the nerve compression was located at the entry point to the cavernous sinus, the so-called oculomotor triangle, in 9/11 (82%) cases and intra cavernous sinus in 2/11 (18%) cases. CONCLUSION:Compression at the oculomotor triangle is considered the main cause of ONP with PA in pituitary adenomas.
journal_name
Acta Neurochir (Wien)journal_title
Acta neurochirurgicaauthors
Sasagawa Y,Aburano H,Ooiso K,Oishi M,Hayashi Y,Nakada Mdoi
10.1007/s00701-020-04632-ysubject
Has Abstractpub_date
2021-02-01 00:00:00pages
383-389issue
2eissn
0001-6268issn
0942-0940pii
10.1007/s00701-020-04632-yjournal_volume
163pub_type
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