{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T22:18:11Z","timestamp":1781734691481,"version":"3.54.5"},"reference-count":16,"publisher":"Georg Thieme Verlag KG","issue":"S 02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg B Skull Base"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Pituitary apoplexy (PA) is a rare complication of pituitary tumors that can present with a myriad of symptoms, including sudden onset cranial nerve deficits. After patient stabilization and hormone replacement, surgical decompression is often recommended. The timing of surgical decompression remains controversial. In this case series, we describe our institutional experience pertaining to the cranial nerve recovery in patients who underwent endoscopic endonasal transsphenoidal (EETS) surgery for PA while evaluating outcome based on tumor stage using the suprasellar infrasellar parasellar anterior posterior (SIPAP) classification.<\/jats:p><jats:p>\n          Design\u2003Present study is a single-institution retrospective cohort.<\/jats:p><jats:p>\n          Methods\u2003A retrospective review of all EETS cases for pituitary tumor resection between November 2009 and August 2018. Queries of the hospital database were completed by trained personnel to identify cases of PA treated using the EETS approach. Baseline characteristics, tumor type, endocrine data, and SIPAP classification based on preoperative magnetic resonance imaging (MRI) and operation characteristics were extracted from medical records. Postoperative results were extracted for the duration of the follow-up period available for each patient.<\/jats:p><jats:p>\n          Results\u2003Fifteen cases of PA were identified. Patient follow-up period was a mean of 30 months. The cranial nerve deficits present at admission were visual deficit (33%); unilateral third nerve palsy (47%) and unilateral sixth nerve palsy (27%). No fourth nerve palsies were observed. Following EETS, 60% of patients with preoperative visual deficit had normal visual fields. For those with third and sixth nerve palsies preoperatively, 43 and 75%, respectively, had return to normal function postoperatively. SIPAP tumor characteristics were not related to postoperative cranial nerve recovery.<\/jats:p><jats:p>\n          Conclusion\u2003In this series of surgically treated patients with pituitary apoplexy, all cranial nerve deficits normalized or improved following surgery. The tumor SIPAP classification was not associated with patient outcome. Though in a small series, the presented results suggest surgical treatment is beneficial for these patients.<\/jats:p>","DOI":"10.1055\/s-0040-1722668","type":"journal-article","created":{"date-parts":[[2021,1,21]],"date-time":"2021-01-21T23:58:26Z","timestamp":1611273506000},"page":"e1-e6","source":"Crossref","is-referenced-by-count":2,"special_numbering":"S","title":["Recovery of Cranial Nerve Deficits in Patients Presenting with Pituitary Apoplexy: A Case Series"],"prefix":"10.1055","volume":"83","author":[{"given":"Mohammed","family":"Alahmari","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4158-2855","authenticated-orcid":false,"given":"Fahad","family":"Alkherayf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Lasso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatmahalzahra","family":"Banaz","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, King Abdulaziz Hospital, Ministry of Health, Jeddah, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sepideh","family":"Mohajeri","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pourya","family":"Masoudian","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre","family":"Lamothe","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Agbi","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Caulley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Alshardan","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1857-7628","authenticated-orcid":false,"given":"Shaun","family":"Kilty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,1,21]]},"reference":[{"issue":"09","key":"ref1","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1002\/alr.21356","article-title":"Significant increases of pituitary tumors and resections from 1993 to 2011","volume":"4","author":"J A Villwock","year":"2014","journal-title":"Int Forum Allergy Rhinol"},{"issue":"02","key":"ref2","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1210\/jcem-71-2-323","article-title":"Improvement of pituitary function after surgical decompression for pituitary tumor apoplexy","volume":"71","author":"B M Arafah","year":"1990","journal-title":"J Clin Endocrinol Metab"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1177\/0885066607312992","article-title":"Pituitary tumor apoplexy: a review","volume":"23","author":"R N Nawar","year":"2008","journal-title":"J Intensive Care Med"},{"issue":"06","key":"ref4","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1227\/00006123-199006000-00010","article-title":"Clinical versus subclinical pituitary apoplexy: presentation, surgical management, and outcome in 21 patients","volume":"26","author":"S T Onesti","year":"1990","journal-title":"Neurosurgery"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1080\/02841859709171238","article-title":"SIPAP--a new MR classification for pituitary adenomas. 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