Neuro-ophthalmologic Recovery Following Endoscopic Endonasal Resection of Pituitary Macro-adenomas with Apoplexy

Background: Pituitary apoplexy is a heterogeneous spectrum and infrequent occurrence that may require timely treatment. There is a controversy about which subsets require urgent as opposed to elective surgical or even medical treatment alone. Objectives: are to study the neuroophthalmologic outcome following endoscopic trans-sphenoidal approach for management of pituitary apoplexy. Patients and Methods: Retrospective analysis of case notes at a single neurosurgical center, Tanta University, Egypt. Twenty Five patients of apoplexy underwent endoscopic trans-sphenoidal approach at Tanta University Hospitals, all patients operated within 48 hours of recent clinical deterioration. Results. The visual field defects had an improvement of 86%. Ocular paresis and ptosis were improved in all patients ranging from 5 days to two weeks following surgery. Twenty patients out of 25 (80%) had gross total resections. Intra-operative bleeding were venous and easily controlled. Cerebrospinal fluid leakage occurred in only one patient. Conclusion. Early endoscopic endo-nasal surgical management is an effective and safe treatment modality for treatment of pituitary apoplexy with mass with a low complication rate..