Isolated third cranial nerve palsy is a rare presentation in a case of pituitary apoplexy

A 50-year-old hypertensive male presented with sudden onset drooping of the left upper eyelid of 28 days duration. Clinical examination revealed left-sided pupil involving third nerve palsy. Imaging studies detected a nonenhancing intrasellar area within the left para-midline anterior pituitary. The mass lesion was resected and the histological study was consistent with a diagnosis of pituitary adenoma complicated with pituitary apoplexy. There was a complete resolution of ptosis one month following the surgical procedure.