An Unusual Presentation of Apoplexy in Nelson's Syndrome: Case Report



Nelson syndrome is a complication of bilateral adrenalectomy performed in some cases of Cushing's disease. In this paper, we report a case of a thirty-six-year-old man with a history of bilateral adrenalectomy for Cushing’s disease five years previously, presented with sudden onset of severe headache, visual disorders, and cranial nerve palsies. The radiological investigation showed a pituitary macoradenoma measuring 33x29x47mm with apoplexy and extension to the left cavernous sinus which was removed through an endonasal endoscopic approach and the histological examination was concomitant with an ACTH-secreting pituitary adenoma. The present work aims to describe a rare presentation of pituitary apoplexy in Nelson’s syndrome patient. This fact would be interesting and must be kept in neurosurgeons’ minds during their daily activity to ameliorate the management of similar cases.

                 Keywords: Cushing disease, Nelson’s syndrome, apoplexy, endonasal endoscopic approach.

Citation: Yacine Felissi, Toufik Bennafaa, Chafik Handis, Salim Meziani, Adel Khelifa, Walid Bennabi and Abdelhalim Morsli “An Unusual Presentation of Apoplexy in Nelson’s Syndrome: Case Report ”. SVOA Neurology 2:2(2021) Pages 47-51.