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Bilateral Cavernous Sinus Syndrome, Pituitary Macroadenoma, and Postoperative Loss of Vision: A Case Report

Moldan, Matthew M. MD; Stewart, Thomas M. MD; Kor, Todd M. MD; Brown, Michael J. MD

doi: 10.1213/XAA.0000000000001083
Case Reports

Postoperative vision loss is a rare complication. When visual loss does occur, it is rarely associated with ophthalmoplegia. We report a case of postoperative bilateral visual field deficits with concomitant complete bilateral ophthalmoplegia in a patient with a known pituitary macroadenoma after surgical excision of a small cell carcinoma of the bladder. Emergency postoperative imaging showed that the macroadenoma had increased in size and was associated with new right optic nerve edema. The patient underwent urgent excision of the macroadenoma 5 days after the onset of symptoms. Visual field deficits and associated ophthalmoplegia had completely resolved at 3-month follow-up.

From the Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota.

Accepted for publication July 19, 2019.

Funding: None.

The authors declare no conflicts of interest.

Address correspondence to Thomas M. Stewart, MD, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55902. Address e-mail to

Copyright © 2019 International Anesthesia Research Society
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