P.156 Outcomes of Cranial Nerve Deficits in Patients with Pituitary Apoplexy: The Ottawa Hospital Experience

Background: One of the rare but urgent presentations of a pituitary tumor is pituitary apoplexy. In this case series, we describe our experience regarding the cranial nerve recovery in patients with pituitary apoplexy following endoscopic endonasal transsphenoidal surgery (EETS). Methods: Retrospective cohort study with patient characteristics, tumor type, endocrine data, operation data collected. Postoperative data were extracted for the follow-up period available for each patient. Results: 15 pituitary apoplexy cases were identified. The cranial nerve deficits presented at admission were: visual deficit (33% patients); unilateral third nerve palsy (47% patients), unilateral sixth nerve palsy (27% patients). Postoperatively, 60% of patients with preoperative visual deficit had normal visual fields and the other 40% showed improvement. From those with oculomotor nerve dysfunction preoperatively, 43% have returned to normal nerve function and 57% presented improvement. 75% cases of abducens nerve palsy resolved postoperatively, while 25% showed improvement. Conclusions: Based on this series, surgical treatment should be offered to patients presenting with cranial nerve deficit in the setting of pituitary apoplexy. In this series, all cranial nerve deficits either returned to normal or improved following surgery. Though a small series, the presented results are superior to those reported in the literature for conservative management.