Use the NF1 and NF2 phenotype to set the workup, and treat pituitary apoplexy as a time-critical emergency when headache, visual loss, and ophthalmoplegia appear together. The next step is urgent steroid support and neurosurgical escalation if vision is threatened.

NF1 often presents with café-au-lait spots, axillary freckling, and optic pathway gliomas; NF2 classically causes bilateral vestibular schwannomas with asymmetric hearing loss; Pituitary apoplexy is a true emergency; Sudden headache, visual loss, and ophthalmoplegia should trigger urgent steroid treatment; Suprasellar masses include meningioma, craniopharyngioma, and optic glioma