Longitudinal splitting of optic pathways by non-functioning pituitary macroadenoma: report of two cases

Acta Neurochir (Wien). 2010 Jun;152(6):1065-8; discussion 1068. doi: 10.1007/s00701-009-0536-6. Epub 2009 Oct 14.


Purpose: Pituitary macroadenomas with suprasellar extension present tight relationships with optic pathways; only one case of optic nerve penetration by a pituitary adenoma has been reported previously.

Methods: We report two cases of patients suffering from non-functioning pituitary macroadenomas with intra-operative findings of longitudinal splitting of the optic pathways.

Results: In both cases the patients were first operated on by a trans-sphenoidal route and the residual suprasellar tumour was resected by a transcranial surgery.

Conclusion: The patients presented a good visual recovery, suggesting that the splitting of the optic pathways has not jeopardised the functional and anatomical integrity of the optic fibres in the reported cases.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Craniotomy
  • Decompression, Surgical
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Microsurgery / methods*
  • Middle Aged
  • Nerve Compression Syndromes / diagnosis
  • Nerve Compression Syndromes / surgery
  • Optic Chiasm
  • Optic Nerve / surgery*
  • Optic Nerve Diseases / diagnosis
  • Optic Nerve Diseases / surgery
  • Pituitary Neoplasms / diagnosis
  • Pituitary Neoplasms / surgery*
  • Reoperation
  • Visual Field Tests
  • Visual Pathways / surgery*