{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:06:50Z","timestamp":1756339610342,"version":"3.44.0"},"reference-count":16,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,4,15]]},"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:p>A 49-year-old man presented with new onset headache and diplopia, with right ptosis and limitation of extraocular movements consistent with a third nerve palsy. He had a known diagnosis of a non-functioning pituitary adenoma, and his presentation and neuroimaging were consistent with ischaemic pituitary apoplexy. The patient was otherwise stable with no signs of optic neuropathy or endocrine abnormality. He was observed with close interval follow-up and reported resolution of symptoms within 4\u2009days after onset. Pituitary apoplexy is a potentially life-threatening condition often managed with initial medical stabilisation followed by neurosurgical decompression. The guidelines regarding the utility of surgery in patients with isolated ocular motility disorders are unclear, and recent retrospective studies suggested that outcomes may be similar in patients managed conservatively. This case demonstrates that rapid resolution of an isolated third nerve palsy may occur in this setting, and that observation is a reasonable initial management strategy.<\/jats:p>","DOI":"10.1136\/bcr-2021-241850","type":"journal-article","created":{"date-parts":[[2021,5,6]],"date-time":"2021-05-06T12:08:44Z","timestamp":1620302924000},"page":"e241850","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Rapid resolution of a third nerve palsy from pituitary apoplexy"],"prefix":"10.1136","volume":"14","author":[{"given":"Verina","family":"Hanna","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zale","family":"Mednick","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4911-9152","authenticated-orcid":false,"given":"Jonathan","family":"Micieli","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,5,6]]},"reference":[{"key":"2025082713133983000_14.5.e241850.1","doi-asserted-by":"crossref","first-page":"188","DOI":"10.4103\/2230-8210.84862","article-title":"Pituitary apoplexy","volume":"15","author":"Ranabir","year":"2011","journal-title":"Indian J Endocrinol Metab"},{"key":"2025082713133983000_14.5.e241850.2","doi-asserted-by":"crossref","first-page":"E533","DOI":"10.1227\/NEU.0000000000001389","article-title":"Congress of neurological surgeons systematic review and evidence-based guideline on primary management of patients with nonfunctioning pituitary adenomas","volume":"79","author":"Lucas","year":"2016","journal-title":"Neurosurgery"},{"key":"2025082713133983000_14.5.e241850.3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2010.03913.x"},{"key":"2025082713133983000_14.5.e241850.4","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1016\/j.wneu.2016.07.026","article-title":"Third, fourth, and sixth cranial nerve palsies in pituitary apoplexy","volume":"94","author":"Hage","year":"2016","journal-title":"World Neurosurg"},{"key":"2025082713133983000_14.5.e241850.5","doi-asserted-by":"crossref","first-page":"1981","DOI":"10.2147\/CIA.S181109","article-title":"Conservative treatment cures an elderly pituitary apoplexy patient with oculomotor paralysis and optic nerve compression: a case report and systematic review of the literature","volume":"13","author":"Fan","year":"2018","journal-title":"Clin Interv Aging"},{"key":"2025082713133983000_14.5.e241850.6","doi-asserted-by":"crossref","unstructured":"Deb T , Sounderajah V , Ratnasabapathy R , et al . 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