Splitting of the Optic Nerve by a Pituitary Macroadenoma

World Neurosurg. 2016 May:89:726.e11-4. doi: 10.1016/j.wneu.2016.01.035. Epub 2016 Jan 22.


Background: Splitting of the optic nerve by a pituitary adenoma is an extremely unusual condition with only 3 cases reported to date.

Case description: A 41-year-old woman presented with visual loss as a result of an aggressive pituitary macroadenoma causing the splitting of the right optic nerve. Possible mechanisms of this condition are discussed, and the literature is reviewed.

Conclusions: In aneurysm and tumor cases, awareness of the exact anatomy is particularly important to preserve function. An overlooked duplication or penetration of cranial nerves may result in inadvertent injury to important structures and loss of function.

Keywords: Optic nerve; Pituitary macroadenoma; Splitting; Visual loss.

Publication types

  • Case Reports

MeSH terms

  • Adenoma / complications*
  • Adenoma / diagnostic imaging
  • Adenoma / surgery
  • Adult
  • Female
  • Humans
  • Ki-67 Antigen / metabolism
  • Magnetic Resonance Imaging
  • Optic Nerve / diagnostic imaging
  • Optic Nerve / pathology*
  • Pituitary Neoplasms / complications*
  • Pituitary Neoplasms / diagnostic imaging
  • Pituitary Neoplasms / surgery
  • Vision Disorders / diagnostic imaging
  • Vision Disorders / etiology*


  • Ki-67 Antigen