Pituitary macroadenoma manifesting as an isolated fourth nerve palsy.
OBJECTIVE
To describe an unusual ophthalmic manifestation of a pituitary adenoma.


METHODS
Case report.


RESULTS
A 32-year-old man had left supraorbital and frontal headaches and new-onset vertical diplopia. Examination showed a left fourth nerve palsy and increased vertical fusional amplitudes. Magnetic resonance imaging disclosed a sellar mass consistent with a pituitary macroadenoma.


CONCLUSIONS
A pituitary adenoma may rarely manifest with an isolated fourth nerve palsy.
Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, USA.
S H
SH
Petermann
N J
NJ
Newman
D000236:Adenoma / Q000175:diagnosis*; D000328:Adult; D003389:Cranial Nerve Diseases / Q000175:diagnosis*; D004172:Diplopia / Q000175:diagnosis; D006261:Headache / Q000175:diagnosis; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009886:Ophthalmoplegia / Q000175:diagnosis*; D010911:Pituitary Neoplasms / Q000175:diagnosis*; D014321:Trochlear Nerve / Q000473:pathology*