{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,9,2]],"date-time":"2023-09-02T11:15:39Z","timestamp":1693653339986},"reference-count":8,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\nBackground: <\/jats:title>\nIsolated oculomotor nerve palsy is a relatively uncommon symptom of pituitary adenoma that usually occurs in association with pituitary apoplexy or cavernous sinus (CS) invasion.<\/jats:p>\n<\/jats:sec>\n\nCase Description: <\/jats:title>\nWe report two cases of relatively small pituitary adenomas with neither apoplexy nor CS invasion presenting as isolated oculomotor nerve palsy. Both patients presented with gradually worsening diplopia, without headache or visual field defects. Magnetic resonance imaging (MRI) showed a pituitary tumor with no evidence of intratumoral hemorrhage. Computed tomography revealed a lateroposterior extension of the tumor with the erosion of the posterior clinoid process. Constructive interference in steady-state MRI revealed compression of the oculomotor nerve by the tumor at the oculomotor triangle. The patients underwent endoscopic transsphenoidal surgery, and the intraoperative findings showed that the tumors did not invade the CS. The tumors were completely resected, and the oculomotor palsies resolved fully.<\/jats:p>\n<\/jats:sec>\n\nConclusion: <\/jats:title>\nThese cases illustrate the need to consider isolated oculomotor nerve palsy as an initial manifestation of a relatively small pituitary adenoma with neither apoplexy nor CS invasion. Based on the characteristic radiological findings, early surgical treatment is recommended to preserve oculomotor function.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_421_2023","type":"journal-article","created":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T06:21:15Z","timestamp":1693549275000},"page":"305","update-policy":"http:\/\/dx.doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pituitary adenoma presenting as isolated oculomotor nerve palsy"],"prefix":"10.25259","volume":"14","author":[{"given":"Jun","family":"Masuoka","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fumitaka","family":"Yoshioka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kohei","family":"Inoue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Furukawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Ito","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Ogata","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukiko","family":"Nakahara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatsuya","family":"Abe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2023,9,1]]},"reference":[{"key":"10.25259\/SNI_421_2023\/ref-1","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1055\/s-2007-979681","article-title":"Third nerve palsies","volume":"27","author":"Bruce","year":"2007","journal-title":"Semin Neurol"},{"key":"10.25259\/SNI_421_2023\/ref-2","doi-asserted-by":"crossref","first-page":"1463","DOI":"10.1016\/j.jocn.2011.02.041","article-title":"Surgical outcome of oculomotor nerve palsy in pituitary adenoma","volume":"18","author":"Chuang","year":"2011","journal-title":"J Clin Neurosci"},{"key":"10.25259\/SNI_421_2023\/ref-3","doi-asserted-by":"crossref","first-page":"315","DOI":"10.3171\/2015.5.JNS15107","article-title":"Pituitary macroadenomas with oculomotor cistern extension and tracking: Implications for surgical management","volume":"125","author":"Hoang","year":"2016","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_421_2023\/ref-4","first-page":"527","article-title":"Meningeal architecture of the cavernous sinus: Clinical and surgical implications","volume":"39","author":"Kawase","year":"1996","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_421_2023\/ref-5","doi-asserted-by":"crossref","first-page":"2453","DOI":"10.1007\/s00701-011-1165-4","article-title":"A possible mechanism of isolated oculomotor nerve palsy by apoplexy of pituitary adenoma without cavernous sinus invasion: A report of two cases","volume":"153","author":"Kobayashi","year":"2011","journal-title":"Acta Neurochir (Wien)"},{"key":"10.25259\/SNI_421_2023\/ref-6","first-page":"ONS-220-7","article-title":"Microsurgical anatomy of the oculomotor cistern","volume":"58","author":"Martins","year":"2006","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_421_2023\/ref-7","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1007\/s00701-020-04632-y","article-title":"Oculomotor nerve palsy in pituitary apoplexy associated with pituitary adenoma: A radiological analysis with fast imaging employing with steady-state acquisition","volume":"163","author":"Sasagawa","year":"2021","journal-title":"Acta Neurochir (Wien)"},{"key":"10.25259\/SNI_421_2023\/ref-8","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1002\/hed.24999","article-title":"Endoscopic endonasal surgery for pituitary adenomas extending to the oculomotor cistern","volume":"40","author":"Taniguchi","year":"2017","journal-title":"Head Neck"}],"container-title":["Surgical Neurology 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