Clinical Effects of Pituitary Tumours in Acromegaly	

Patients may present with headaches due to dural stretching. The pituitary fossa is enlarged in over ninety-five per cent of cases (Fig. 3.13). Upward extension of the pituitary tumour, when present, may cause a characteristic bitemporal field defect best found with the Goldmann perimeter. The enlarged supraorbital ridges may produce technical problems with visual field plotting; this is therefore best performed by tilting the head backwards by twenty degrees. Lateral extension of the tumour may cause third, fourth and sixth cranial nerve palsies and, more rarely, temporal lobe epilepsy. Erosion into the sphenoid sinus may be associated with cerebrospinal fluid (CSF) rhinorrhoea. 

See also:
• Local Effects Hypothalamic or Pituitary Lesions