Postoperative pituitary apoplexy is rare and usually occurs in the immediate postoperative period (within 12 hours) after subtotal resection of giant pituitary macroadenomas with fatal outcomes. We describe a unique case of postoperative pituitary apoplexy occurring in a delayed fashion on the third postoperative day. Early detection and emergent endoscopic transsphenoidal exploration resulted in gross total removal of the residual tumor, decompression of the optic chiasm, and a favorable neurologic outcome. The authors review the literature of postoperative pituitary apoplexy and emphasize the importance of rapid diagnosis and intervention in order to achieve significant recovery and a favorable neurologic outcome.
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