23rd May 2025

A 65-year-old male presents to A&E after developing worsening headaches, nausea and vomiting, and diplopia for the last two weeks.

A 65-year-old male presents to A&E after developing worsening headaches, nausea and vomiting, and diplopia for the last two weeks. Observations showed tachycardia. Initial bloods, ECG and chest X-Ray were normal. On examination, he was found to have cranial nerve palsies of nerves III, IV and VI as well as a bitemporal hemianopia. The patient also had some neck stiffness and photophobia. Further bloods showed low ACTH, cortisol, TSH and testosterone. 

What is the most important initial medical treatment for his condition?

Select the SINGLE most appropriate option from the list below. Select ONE option only.