Abstract
The co-existence of pituitary adenomas (PA) and carotid artery aneurysms has been described and may be particularly frequent in acromegaly. The co-occurrence of an intracranial aneurysm in the setting of a PA presents significant risk to the patient, particularly when the aneurysm is within or near the operative field. We describe a 48-year-old, right-handed female patient with a large skull base lesion who had a left cavernous carotid artery aneurysm detected on her preoperative imaging studies. This patient was managed using a staged approach. She first underwent endovascular stent-assisted coiling of the aneurysm followed, six months later, by resection of the tumor via an expanded endonasal endoscopic approach. Histopathological analysis revealed a pituitary macroadenoma with neuronal metaplasia. Angiographic embolization followed by an expanded endonasal endoscopic approach is a safe and effective treatment for such lesions. Vascular imaging studies and a low index for suspicion are required for preoperative identification of such complex situations.
Original language | English (US) |
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Pages (from-to) | 1437-1441 |
Number of pages | 5 |
Journal | Journal of Clinical Neuroscience |
Volume | 19 |
Issue number | 10 |
DOIs | |
State | Published - Oct 1 2012 |
Keywords
- Cavernous carotid artery aneurysm
- Coiling
- Endoscopy
- Expanded endonasal endoscopic approach
- Neuronal metaplasia
- Pituitary macroadenoma
ASJC Scopus subject areas
- Surgery
- Neurology
- Clinical Neurology
- Physiology (medical)