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Record W3159403239 · doi:10.1136/bcr-2021-241850

Rapid resolution of a third nerve palsy from pituitary apoplexy

2021· article· en· W3159403239 on OpenAlexaff
Verina Hanna, Zale Mednick, Jonathan A. Micieli

Bibliographic record

VenueBMJ Case Reports · 2021
Typearticle
Languageen
FieldMedicine
TopicPituitary Gland Disorders and Treatments
Canadian institutionsUniversity of Toronto
Fundersnot available
KeywordsMedicinePituitary apoplexyDiplopiaPalsyPituitary adenomaPtosisOculomotor nerve palsyTrochlear nerveOculomotor nerveAbducens nerveSurgeryExtraocular musclesAbnormalityPresentation (obstetrics)AdenomaInternal medicinePathology

Abstract

fetched live from OpenAlex

A 49-year-old man presented with new onset headache and diplopia, with right ptosis and limitation of extraocular movements consistent with a third nerve palsy. He had a known diagnosis of a non-functioning pituitary adenoma, and his presentation and neuroimaging were consistent with ischaemic pituitary apoplexy. The patient was otherwise stable with no signs of optic neuropathy or endocrine abnormality. He was observed with close interval follow-up and reported resolution of symptoms within 4 days after onset. Pituitary apoplexy is a potentially life-threatening condition often managed with initial medical stabilisation followed by neurosurgical decompression. The guidelines regarding the utility of surgery in patients with isolated ocular motility disorders are unclear, and recent retrospective studies suggested that outcomes may be similar in patients managed conservatively. This case demonstrates that rapid resolution of an isolated third nerve palsy may occur in this setting, and that observation is a reasonable initial management strategy.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.005
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Case report · Consensus signal: Case report
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.003
Threshold uncertainty score0.009

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0000.005
Meta-epidemiology (narrow)0.0010.001
Meta-epidemiology (broad)0.0010.001
Bibliometrics0.0020.001
Science and technology studies0.0020.002
Scholarly communication0.0010.001
Open science0.0010.001
Research integrity0.0030.005
Insufficient payload (model declined to judge)0.0020.001

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.029
GPT teacher head0.296
Teacher spread0.267 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designCase report
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations3
Published2021
Admission routes1
Has abstractyes

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