Detection of oculomotor nerve compression by 3D-FIESTA MRI in a patient with pituitary apoplexy and diabetes mellitus
We report the usefulness of 3D-FIESTA magnetic resonance imaging(MRI)for the detection of oculomotor nerve palsy in a case of pituitary apoplexy. A 69-year-old man with diabetes mellitus presented with complete left-side blepharoptosis. Computed tomography of the brain showed an intrasellar mass with hemorrhage. MRI demonstrated a pituitary adenoma with a cyst toward the left cavernous sinus, which was diagnosed as pituitary apoplexy. 3D-FIESTA revealed that the left oculomotor nerve was compressed by the cyst. He underwent trans-sphenoid tumor resection at 5 days after his hospitalization. Post-operative 3D-FIESTA MRI revealed decrease in compression of the left oculomotor nerve by the cyst. His left oculomotor palsy recovered completely within a few months. Oculomotor nerve palsy can occur due to various diseases, and 3D-FIESTA MRI is useful for detection of oculomotor nerve compression, especially in the field of parasellar lesions.
Pituitary Apoplexy, Arthrogryposis Multiplex Congenita, Brown Syndrome, Hypothalamic Tumor, Tomaculous Neuropathy, Spinal Muscular Atrophy Type 2, Primary Lateral Sclerosis, Congenital Contractures, Spinal Muscular Atrophy Type 3, Brain Tumor, Apoplexy, Spinal Muscular Atrophy with Arthrogryposis, Spinal Muscular Atrophy (SMA), Pituitary Tumor