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Updated: Aug 2, 2025

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
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Published on: January 17, 2018

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Clinical Features of Pituitary or Parasellar Tumor Onset with Cranial Nerve Palsy: Surgical Intervention

Yuichi Oda1, Kosaku Amano1, Kenta Masui2

  • 1Department of Neurosurgery, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan.

World Neurosurgery
|April 16, 2023
PubMed
Abstract

Insights

Pituitary tumors can cause cranial nerve palsy (CNP). Surgical intervention for these rare tumors improves symptoms and recovery time, with most patients experiencing full recovery.

Area of Science:

  • Neurosurgery
  • Neurology
  • Endocrinology

Background:

  • Pituitary and parasellar tumors are rare.
  • Cranial nerve palsy (CNP) is an uncommon presenting symptom of these tumors.
  • Understanding the mechanisms and optimal treatment for CNP in this context is crucial.

Purpose of the Study:

  • To clarify the symptoms associated with pituitary or parasellar tumors presenting with CNP.
  • To enhance knowledge regarding this rare symptom and its most effective treatment strategies.
  • To evaluate the neurological symptoms, pathological diagnoses, and recovery outcomes in patients with CNP due to pituitary/parasellar tumors.

Main Methods:

  • Retrospective review of 1281 surgically treated pituitary/parasellar tumors (2003-2020).
  • Analysis of 30 cases presenting initially with CNP.
  • Evaluation of neurological symptoms, histological diagnosis, surgical timing, and CNP recovery.

Main Results:

  • CNP was the initial presentation in 2.34% of patients.
  • Common causes included pituitary apoplexy, nerve compression, and inflammation.
  • Oculomotor nerve palsy was most frequent (66.7%), followed by abducens (43.3%) and trochlear (6.7%).
  • Complete CNP recovery occurred in 83.3% after surgery alone.
  • Early surgery did not impact recovery rates but reduced recovery time.

Conclusions:

  • Determining the mechanism of CNP is critical for effective intervention.
  • Surgical treatment improves symptoms, shortens recovery duration, and prevents relapses.
  • Accurate pathological diagnosis guides appropriate adjuvant therapy selection.
Keywords:
Cranial nerve palsyParasellar tumorPituitary apoplexyPituitary tumorSkull baseSurgical intervention

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