Neurological examination

Neurological examination includes the identification of cerebral and focal symptoms.

Cerebral symptoms in diseases of the pituitary gland are most often manifested as a bursting headache. In case of neoplasms of the chiasmal-sellar region, which grow to a considerable size, especially with occlusion of the interventricular orifice (Monroe), the so-called “hypertensive” symptoms may appear, such as nausea, vomiting, etc.
Focal symptoms occur depending on the direction of growth of the tumor in relation to the Turkish saddle (Sella Turcica):
• The endosellar location of the neoplasm (inside the Sella Turcica) causes no focal neurological symptoms.
• Suprasellar dissemination – visual impairment of varying degrees of severity (“Chiasmatic syndrome” – reduced visual acuity; homo / bitemporal hemianopsia; primary optic atrophy).
• Infrasellar dissemination – in a significant growth of a neoplasm, symptoms such as impaired nasal breathing, changes in voice tone, swallowing, etc. may occur.
• Retrosellar dissemination – the presence of severe stem disorders.
• Antecellular dissemination – the growth of a neoplasm in an orbit or a trellised labyrinth, may be accompanied by exophthalmos, pain in the orbit, visual/oculomotor disorders, and hypoosmia.
• Laterosellar dissemination – can cause “cavernous sinus syndrome” i.e. damage to cranial nerves III, IV, VI, V1, as well as exophthalmos, chemosis, etc.