Presentation

• Pituitary Stalk Effect → Prolactin

• Non-specific Headache

• Effect on cranial nerves

  • CN II
    • RAPD
    • Decreased red perception
    • Blurry Vision → Snellen chart (Visual Acuity)
    • Pale optic disc →Fundoscope
    • Bitemporal hemianopsia
  • CN III, IV, VI
    • BinocularDiplopia → H test - EOM
  • CN V1, V2
    • Facial Numbness → Sensory Exam

Investigation

• Physical Exams listed above
• Formal visual field assessment
• Brain MRI

Treatment

• Surgery: Trans-sphenoid Surgery
• Symptomatic management