{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T23:25:12Z","timestamp":1769729112025,"version":"3.49.0"},"reference-count":24,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"14","license":[{"start":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T00:00:00Z","timestamp":1727654400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2024,9,30]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Giant pituitary prolactinomas are rare entities that can present with pituitary apoplexy and acute neurological decline. Isolated acute hypoglossal nerve palsy is an extremely rare presentation that is not well described in the literature. The authors describe the case of a giant prolactin-secreting adenoma with apoplexy that presented with isolated bilateral hypoglossal palsy, followed by a brief review of the literature and management strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 62-year-old female with a history of neck pain presented after a syncopal episode with dysarthria and dysphagia attributed to bilateral hypoglossal nerve palsies. Magnetic resonance imaging revealed a giant apoplectic pituitary tumor with extensive suprasellar and clival extension, including clear invasion of bilateral occipital condyles on computed tomography. The patient underwent urgent endoscopic transsphenoidal decompression and debulking of her tumor and was started on medical therapy with immediate, significant improvement in the bilateral hypoglossal nerve palsies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Prolactinomas presenting with acute neurological decline, including bilateral hypoglossal nerve palsy, can benefit from urgent endoscopic transsphenoidal surgical decompression and safe debulking. Bilateral condylar tumor invasion may not always require craniocervical surgical fixation in the acute setting. Patients should be followed up and monitored clinically and radiographically for any signs of craniocervical instability after the initiation of medical therapy.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE24326\">https:\/\/thejns.org\/doi\/10.3171\/CASE24326<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case24326","type":"journal-article","created":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T04:38:13Z","timestamp":1727671093000},"source":"Crossref","is-referenced-by-count":0,"title":["Giant pituitary macroadenoma with apoplexy presenting with isolated bilateral hypoglossal nerve palsy: illustrative case"],"prefix":"10.3171","volume":"8","author":[{"given":"Mazen","family":"Zaher","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery, Cooper University, Camden, New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Devin W","family":"Kolmetzky","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, Cooper University, Camden, New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zein","family":"Al-Atrache","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, Cooper University, Camden, New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Swar","family":"Vimawala","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology\u2013Head and Neck Surgery, Cooper University, Camden, New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadeem R","family":"Kolia","sequence":"additional","affiliation":[{"name":"Departments of Otolaryngology\u2013Head and Neck Surgery, Cooper University, Camden, New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saniya S","family":"Godil","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, Cooper University, Camden, New Jersey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"9","key":"bib1","series-title":"J Stroke Cerebrovasc Dis","first-page":"105969","article-title":"Isolated third cranial nerve palsy in pituitary apoplexy: case report and systematic review","volume":"30","author":"Rosso","year":"2021","unstructured":"Rosso MRamaswamy SSucharew HVagal AAnziska YLevine SR. Isolated third cranial nerve palsy in pituitary apoplexy: case report and systematic review. J Stroke Cerebrovasc Dis. 2021;30(9):105969."},{"issue":"4","key":"bib2","series-title":"Acta Neurol Belg","first-page":"1031","article-title":"Analysis of visual field disturbance in patients with sellar and suprasellar lesions: relationship with magnetic resonance imaging findings and sagittal bending of the optic nerve","volume":"122","author":"Yamaguchi","year":"2022","unstructured":"Yamaguchi RTosaka MShinohara Y, et al. Analysis of visual field disturbance in patients with sellar and suprasellar lesions: relationship with magnetic resonance imaging findings and sagittal bending of the optic nerve. Acta Neurol Belg. 2022;122(4):1031-1041."},{"issue":"3","key":"bib3","series-title":"Surg Neurol","first-page":"280","article-title":"Cavernous sinus syndrome due to prolactinoma: resolution with bromocriptine","volume":"19","author":"King","year":"1983","unstructured":"King LWMolitch MEGittinger JWJrWolpert SMStern J. Cavernous sinus syndrome due to prolactinoma: resolution with bromocriptine. Surg Neurol. 1983;19(3):280-284."},{"issue":"3","key":"bib4","series-title":"Br J Ophthalmol","first-page":"188","article-title":"Ptosis as the early manifestation of pituitary tumour","volume":"74","author":"Yen","year":"1990","unstructured":"Yen MYLiu JHJaw SJ. Ptosis as the early manifestation of pituitary tumour. Br J Ophthalmol. 1990;74(3):188-191."},{"issue":"1","key":"bib5","series-title":"J Neurosurg","first-page":"17","article-title":"Ocular palsy occurring with pituitary tumors","volume":"38","author":"Robert","year":"1973","unstructured":"Robert CMJrFeigenbaum JAStern EW. Ocular palsy occurring with pituitary tumors. J Neurosurg. 1973;38(1):17-19."},{"issue":"2","key":"bib6","series-title":"Am J Ophthalmol","first-page":"235","article-title":"Pituitary macroadenoma manifesting as an isolated fourth nerve palsy","volume":"127","author":"Petermann","year":"1999","unstructured":"Petermann SHNewman NJ. Pituitary macroadenoma manifesting as an isolated fourth nerve palsy. Am J Ophthalmol. 1999;127(2):235-236."},{"issue":"275","key":"bib7","series-title":"Q J Med","first-page":"227","article-title":"Giant invasive prolactinoma: a case report and review of nine further cases","volume":"74","author":"Davis","year":"1990","unstructured":"Davis JRSheppard MCHeath DA. Giant invasive prolactinoma: a case report and review of nine further cases. Q J Med. 1990;74(275):227-238."},{"issue":"1","key":"bib8","series-title":"JAMA Otolaryngol Head Neck Surg","first-page":"82","article-title":"Giant pituitary adenoma with inferior petrosal sinus, jugular foramen, and hypoglossal canal extension","volume":"146","author":"Kuo","year":"2020","unstructured":"Kuo AHNu\u00f1ez DB. Giant pituitary adenoma with inferior petrosal sinus, jugular foramen, and hypoglossal canal extension. JAMA Otolaryngol Head Neck Surg. 2020;146(1):82-84."},{"issue":"12","key":"bib9","series-title":"Arch Pathol Lab Med","first-page":"1188","article-title":"A fatal invasive prolactin-producing pituitary adenoma causing hypoglossal nerve paresis","volume":"110","author":"Witrak","year":"1986","unstructured":"Witrak GAZlonis MSLarson DM. A fatal invasive prolactin-producing pituitary adenoma causing hypoglossal nerve paresis. Arch Pathol Lab Med. 1986;110(12):1188-1189."},{"issue":"4","key":"bib10","series-title":"Endocrinologist","first-page":"331","article-title":"Giant prolactinoma causing isolated twelfth cranial nerve palsy: case report and review of patterns of extra sellar invasion by pituitary tumors","volume":"11","author":"Kline","year":"2001","unstructured":"Kline GMCorenblum BHamilton M. Giant prolactinoma causing isolated twelfth cranial nerve palsy: case report and review of patterns of extra sellar invasion by pituitary tumors. Endocrinologist. 2001;11(4):331-334."},{"issue":"6","key":"bib11","series-title":"Insights Imaging","first-page":"753","article-title":"Pituitary apoplexy: an update on clinical and imaging features","volume":"5","author":"Boellis","year":"2014","unstructured":"Boellis Adi Napoli ARomano ABozzao A. Pituitary apoplexy: an update on clinical and imaging features. Insights Imaging. 2014;5(6):753-762."},{"issue":"23","key":"bib12","series-title":"J Neurosurg Case Lessons","first-page":"CASE2158","article-title":"Management of giant prolactinoma causing craniocervical instability: illustrative case","volume":"1","author":"Chugh","year":"2021","unstructured":"Chugh AJSPatel MChua LArafah BBambakidis NCRay A. Management of giant prolactinoma causing craniocervical instability: illustrative case. J Neurosurg Case Lessons. 2021;1(23):CASE2158."},{"issue":"9","key":"bib1","series-title":"J Stroke Cerebrovasc Dis","first-page":"105969","article-title":"Isolated third cranial nerve palsy in pituitary apoplexy: case report and systematic review","volume":"30","author":"Rosso","year":"2021","unstructured":"Rosso MRamaswamy SSucharew HVagal AAnziska YLevine SR. Isolated third cranial nerve palsy in pituitary apoplexy: case report and systematic review. J Stroke Cerebrovasc Dis. 2021;30(9):105969."},{"issue":"4","key":"bib2","series-title":"Acta Neurol Belg","first-page":"1031","article-title":"Analysis of visual field disturbance in patients with sellar and suprasellar lesions: relationship with magnetic resonance imaging findings and sagittal bending of the optic nerve","volume":"122","author":"Yamaguchi","year":"2022","unstructured":"Yamaguchi RTosaka MShinohara Y, et al. Analysis of visual field disturbance in patients with sellar and suprasellar lesions: relationship with magnetic resonance imaging findings and sagittal bending of the optic nerve. Acta Neurol Belg. 2022;122(4):1031-1041."},{"issue":"3","key":"bib3","series-title":"Surg Neurol","first-page":"280","article-title":"Cavernous sinus syndrome due to prolactinoma: resolution with bromocriptine","volume":"19","author":"King","year":"1983","unstructured":"King LWMolitch MEGittinger JWJrWolpert SMStern J. Cavernous sinus syndrome due to prolactinoma: resolution with bromocriptine. Surg Neurol. 1983;19(3):280-284."},{"issue":"3","key":"bib4","series-title":"Br J Ophthalmol","first-page":"188","article-title":"Ptosis as the early manifestation of pituitary tumour","volume":"74","author":"Yen","year":"1990","unstructured":"Yen MYLiu JHJaw SJ. Ptosis as the early manifestation of pituitary tumour. Br J Ophthalmol. 1990;74(3):188-191."},{"issue":"1","key":"bib5","series-title":"J Neurosurg","first-page":"17","article-title":"Ocular palsy occurring with pituitary tumors","volume":"38","author":"Robert","year":"1973","unstructured":"Robert CMJrFeigenbaum JAStern EW. Ocular palsy occurring with pituitary tumors. J Neurosurg. 1973;38(1):17-19."},{"issue":"2","key":"bib6","series-title":"Am J Ophthalmol","first-page":"235","article-title":"Pituitary macroadenoma manifesting as an isolated fourth nerve palsy","volume":"127","author":"Petermann","year":"1999","unstructured":"Petermann SHNewman NJ. Pituitary macroadenoma manifesting as an isolated fourth nerve palsy. Am J Ophthalmol. 1999;127(2):235-236."},{"issue":"275","key":"bib7","series-title":"Q J Med","first-page":"227","article-title":"Giant invasive prolactinoma: a case report and review of nine further cases","volume":"74","author":"Davis","year":"1990","unstructured":"Davis JRSheppard MCHeath DA. Giant invasive prolactinoma: a case report and review of nine further cases. Q J Med. 1990;74(275):227-238."},{"issue":"1","key":"bib8","series-title":"JAMA Otolaryngol Head Neck Surg","first-page":"82","article-title":"Giant pituitary adenoma with inferior petrosal sinus, jugular foramen, and hypoglossal canal extension","volume":"146","author":"Kuo","year":"2020","unstructured":"Kuo AHNu\u00f1ez DB. Giant pituitary adenoma with inferior petrosal sinus, jugular foramen, and hypoglossal canal extension. JAMA Otolaryngol Head Neck Surg. 2020;146(1):82-84."},{"issue":"12","key":"bib9","series-title":"Arch Pathol Lab Med","first-page":"1188","article-title":"A fatal invasive prolactin-producing pituitary adenoma causing hypoglossal nerve paresis","volume":"110","author":"Witrak","year":"1986","unstructured":"Witrak GAZlonis MSLarson DM. A fatal invasive prolactin-producing pituitary adenoma causing hypoglossal nerve paresis. Arch Pathol Lab Med. 1986;110(12):1188-1189."},{"issue":"4","key":"bib10","series-title":"Endocrinologist","first-page":"331","article-title":"Giant prolactinoma causing isolated twelfth cranial nerve palsy: case report and review of patterns of extra sellar invasion by pituitary tumors","volume":"11","author":"Kline","year":"2001","unstructured":"Kline GMCorenblum BHamilton M. Giant prolactinoma causing isolated twelfth cranial nerve palsy: case report and review of patterns of extra sellar invasion by pituitary tumors. Endocrinologist. 2001;11(4):331-334."},{"issue":"6","key":"bib11","series-title":"Insights Imaging","first-page":"753","article-title":"Pituitary apoplexy: an update on clinical and imaging features","volume":"5","author":"Boellis","year":"2014","unstructured":"Boellis Adi Napoli ARomano ABozzao A. Pituitary apoplexy: an update on clinical and imaging features. Insights Imaging. 2014;5(6):753-762."},{"issue":"23","key":"bib12","series-title":"J Neurosurg Case Lessons","first-page":"CASE2158","article-title":"Management of giant prolactinoma causing craniocervical instability: illustrative case","volume":"1","author":"Chugh","year":"2021","unstructured":"Chugh AJSPatel MChua LArafah BBambakidis NCRay A. Management of giant prolactinoma causing craniocervical instability: illustrative case. J Neurosurg Case Lessons. 2021;1(23):CASE2158."}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/8\/14\/article-CASE24326.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/8\/14\/article-CASE24326.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/8\/14\/article-CASE24326.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T11:51:57Z","timestamp":1769687517000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/8\/14\/article-CASE24326.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,30]]},"references-count":24,"journal-issue":{"issue":"14"},"URL":"https:\/\/doi.org\/10.3171\/case24326","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,30]]}}}